Healthcare Provider Details

I. General information

NPI: 1962468900
Provider Name (Legal Business Name): NYINGI MUNANYO KEMMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 BAYSHORE BLVD.
TAMPA FL
33606-2707
US

IV. Provider business mailing address

409 BAYSHORE BLVD.
TAMPA FL
33606-2707
US

V. Phone/Fax

Practice location:
  • Phone: 800-844-9302
  • Fax: 813-844-1655
Mailing address:
  • Phone: 800-844-9302
  • Fax: 813-844-1655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-084583
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME109322
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35-084583
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number35.084583
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberME109322
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: