Provider Demographics
NPI:1346710472
Name:WARD, KYLE (ARNP)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 FREESTYLE LN
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-0013
Mailing Address - Country:US
Mailing Address - Phone:352-978-1310
Mailing Address - Fax:
Practice Address - Street 1:7800 FREESTYLE LN
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-0013
Practice Address - Country:US
Practice Address - Phone:352-978-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-02
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11180761363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner