Provider Demographics
NPI:1689754517
Name:ALONSO, KIMBERLY KARRA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:KARRA
Last Name:ALONSO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10305 TIMMONS RD
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-3354
Mailing Address - Country:US
Mailing Address - Phone:813-690-9722
Mailing Address - Fax:813-986-8794
Practice Address - Street 1:10305 TIMMONS RD
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-3354
Practice Address - Country:US
Practice Address - Phone:813-690-9722
Practice Address - Fax:813-986-8794
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1123225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist