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General NPI Number Information
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NPI Number | 1780955997
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Entity Type | Organization
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Legal Business Name | KIM B. POWERS, D.O., P.A.
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 7800 66TH ST N STE 206
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2101
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Country | US
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Telephone | 727-541-0323
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Fax | 727-541-0336
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Provider Business Mailing Address
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Address Line | 7800 66TH ST N STE 206
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2101
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Country | US
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Telephone | 727-541-0323
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Fax | 727-541-0336
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Authorized Official
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Title or Position | OWNER
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Name | KIM BARTHOLOMEW POWERS
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Credential | D.O.
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Telephone | 727-541-0323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | OS6697
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License Number State | FL
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