Healthcare Provider Details

I. General information

NPI: 1518798065
Provider Name (Legal Business Name): KIMBULL CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE RD. BUILDING E, SUITE H
SARASOTA FL
34233
US

IV. Provider business mailing address

PO BOX 17091
SARASOTA FL
34276-0091
US

V. Phone/Fax

Practice location:
  • Phone: 941-313-8810
  • Fax:
Mailing address:
  • Phone: 941-313-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA SUSAN MORSE
Title or Position: MANAGING PARTNER
Credential: PA-C
Phone: 941-539-4469