Individual provider · NPI-1

Dr. Kimberly W Gaston, DC, MD

General Practice · Hollywood, FL

NPI number1801837281
StatusActive
Last updated in NPPESSep 13, 2024

Details

NPI
1801837281
Entity type
Individual (NPI-1)
Name
Dr. Kimberly W Gaston
Credential
DC, MD
Sex
Female
Sole proprietor
No
Enumeration date
Jun 9, 2006
Certification date
Sep 13, 2024
Last updated
Sep 13, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General PracticeME168965FLYes
2081P2900X Physical Medicine & Rehabilitation, Pain MedicineME168965FL

Practice location

6067 Hollywood Blvd Ste 203
Hollywood, FL 33024-7922

Phone 309-370-7427

Mailing address

6067 Hollywood Blvd Ste 203
Hollywood, FL 33024-7922

Phone 309-370-7427

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