Basic Information
| Provider Information | |||||||||
| NPI: | 1003142373 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VERBARG | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | L.M. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 215 LITHIA PINECREST RD | ||||||||
| Address2: | |||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335115307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136858404 | ||||||||
| FaxNumber: | 8132980620 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 LITHIA PINECREST RD | ||||||||
| Address2: | |||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136858404 | ||||||||
| FaxNumber: | 8132980620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2009 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | MW 230 | FL | Y | Other Service Providers | Midwife |
No ID Information.