Provider Demographics
NPI:1033221510
Name:PARROW, KYLE A (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:A
Last Name:PARROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N LECANTO HWY
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-9191
Mailing Address - Country:US
Mailing Address - Phone:352-746-2246
Mailing Address - Fax:352-746-2807
Practice Address - Street 1:240 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9191
Practice Address - Country:US
Practice Address - Phone:352-746-2246
Practice Address - Fax:352-746-2807
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060384207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1033221510OtherNPI
FL12543OtherBCBS
180024625OtherRAILROAD MEDICARE
FL054680100Medicaid
FL054680100Medicaid
180024625OtherRAILROAD MEDICARE
12543ZMedicare PIN