Provider Demographics
NPI:1720676703
Name:BORRELLI, KIMBERLY CLAIRE (HAS)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CLAIRE
Last Name:BORRELLI
Suffix:
Gender:
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12028 CITRUS FALLS CIR APT 208
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5725
Mailing Address - Country:US
Mailing Address - Phone:803-645-7072
Mailing Address - Fax:
Practice Address - Street 1:6906 W LINEBAUGH AVE STE 101
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5830
Practice Address - Country:US
Practice Address - Phone:813-962-1888
Practice Address - Fax:813-369-5337
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5800237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist