Provider Demographics
NPI:1265810899
Name:BRIZELL, KIMBERLY ANN (DO)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:BRIZELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RIVERFRONT BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8823
Mailing Address - Country:US
Mailing Address - Phone:841-748-2417
Mailing Address - Fax:941-748-3694
Practice Address - Street 1:101 RIVERFRONT BLVD STE 700
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8823
Practice Address - Country:US
Practice Address - Phone:841-748-2417
Practice Address - Fax:941-748-3694
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14704207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology