Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | MA33839 | FL |
Y | 226300000X | Kinesiotherapist |
NPI | 1548201221 |
---|---|
Provider Name | Kim Floore |
First Address | St Petersburg, FL 33713-6709 |
Second Address | Tampa, FL 33612-4745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 12/02/2013 |