Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN11014623 | FL |
NPI | 1043984610 |
---|---|
Provider Name | Dr. Kimberly Michelle Mockel |
First Address | St Petersburg, FL 33711-1203 |
Second Address | Tampa, FL 33606-3571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2021 |
Last Update Date | 05/08/2021 |