Provider Demographics
NPI:1518472174
Name:HOOPER, KYLE MATTHEW
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:MATTHEW
Last Name:HOOPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7181 COLLEGE PKWY STE 14
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5642
Mailing Address - Country:US
Mailing Address - Phone:239-275-7655
Mailing Address - Fax:239-275-6889
Practice Address - Street 1:7181 COLLEGE PKWY STE 14
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5642
Practice Address - Country:US
Practice Address - Phone:239-275-7655
Practice Address - Fax:239-275-6889
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4468237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist