Provider Demographics
NPI:1558066563
Name:PRIVETTE, CHRISTOPHER KYLE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KYLE
Last Name:PRIVETTE
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:DELRAY MEDICAL CENTER - FAIR OAKS PAVILION #247
Mailing Address - Street 2:5440 LINTON BLVD
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484
Mailing Address - Country:US
Mailing Address - Phone:561-334-6240
Mailing Address - Fax:561-495-3467
Practice Address - Street 1:DELRAY MEDICAL CENTER - FAIR OAKS PAVILION #247
Practice Address - Street 2:5440 LINTON BLVD
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-334-6240
Practice Address - Fax:561-495-3467
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program