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General NPI Number Information
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NPI Number | 1457359192
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Entity Type | Individual
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Provider Name | KIMBERLY ANN PHILLIPS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 1312 E LUMSDEN RD
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City | BRANDON
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State | FL
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Zip | 33511-6717
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Country | US
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Telephone | 813-409-3998
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Fax | 800-379-8041
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Provider Business Mailing Address
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Address Line | 1312 E LUMSDEN RD STE 304
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City | BRANDON
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State | FL
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Zip | 33511-6717
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Country | US
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Telephone | 813-409-3998
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Fax | 800-379-8041
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036960
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME142657
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME142657
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License Number State | FL
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