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General NPI Number Information
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NPI Number | 1326511007
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Entity Type | Organization
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Legal Business Name | PARKINSONS & MEMORY CENTER PA
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Dates
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Enumeration Date | 01/06/2019
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Last Update Date | 01/06/2019
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Provider Practice Location Address
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Address Line | 919 N OSPREY AVE # B
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City | SARASOTA
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State | FL
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Zip | 34236-4143
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Country | US
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Telephone | 917-691-5751
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Fax |
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Provider Business Mailing Address
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Address Line | 919 N OSPREY AVE # B
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City | SARASOTA
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State | FL
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Zip | 34236-4143
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Country | US
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Telephone | 917-691-5751
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TARA KIMBASON
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Credential | MD
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Telephone | 941-691-5751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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