Provider Demographics
NPI:1437471661
Name:DURAN, KIMBERLY A (MSW; FL EDUCATOR)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:A
Last Name:DURAN
Suffix:
Gender:F
Credentials:MSW; FL EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 MAGNOLIA BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-5427
Mailing Address - Country:US
Mailing Address - Phone:813-504-4857
Mailing Address - Fax:
Practice Address - Street 1:9535 MAGNOLIA BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-5427
Practice Address - Country:US
Practice Address - Phone:813-504-4857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10010481041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool