Provider Demographics
NPI:1528947447
Name:LOVE, KIMBERLY SHEA (LMT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SHEA
Last Name:LOVE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1877 SOUTHPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5337
Mailing Address - Country:US
Mailing Address - Phone:615-948-5745
Mailing Address - Fax:
Practice Address - Street 1:2805 FRUITVILLE RD STE 250
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5385
Practice Address - Country:US
Practice Address - Phone:615-948-5745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL96785225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty