Healthcare Provider Details

I. General information

NPI: 1366209934
Provider Name (Legal Business Name): KIMBERLY STREIFF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 JOHNSON RD
PLANT CITY FL
33566-0568
US

IV. Provider business mailing address

1201 JOHNSON RD
PLANT CITY FL
33566-0568
US

V. Phone/Fax

Practice location:
  • Phone: 863-393-7318
  • Fax:
Mailing address:
  • Phone: 863-393-7318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11046331
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9454376
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: