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General NPI Number Information
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NPI Number | 1780179721
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Entity Type | Individual
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Provider Name | KIMBERLY PAULEY MEAGHER DPT
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Gender | Female
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 4406 S FLORIDA AVE STE 16
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City | LAKELAND
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State | FL
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Zip | 33813-2182
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Country | US
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Telephone | 863-688-1800
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Fax | 636-881-8248
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Provider Business Mailing Address
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Address Line | 4406 S FLORIDA AVE STE 16
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City | LAKELAND
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State | FL
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Zip | 33813-2182
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Country | US
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Telephone | 636-881-8008
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Fax | 863-688-1824
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT35197
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License Number State | FL
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