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General NPI Number Information
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NPI Number | 1114357456
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Entity Type | Individual
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Provider Name | SEAN M. KIBRIA DPM
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Gender | Male
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Dates
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Enumeration Date | 11/23/2013
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 5475 GOLDEN GATE PARKWAY STE 4
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City | NAPLES
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State | FL
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Zip | 34116-7529
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Country | US
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Telephone | 239-238-8925
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Fax | 239-353-7001
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Provider Business Mailing Address
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Address Line | 5475 GOLDEN GATE PARKWAY STE 4
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City | NAPLES
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State | FL
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Zip | 34116-7529
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Country | US
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Telephone | 239-238-8925
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Fax | 239-353-7001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3769
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO3769
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License Number State | FL
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