Provider Demographics
NPI:1558847541
Name:KYLE LINSEY DO PA
Entity Type:Organization
Organization Name:KYLE LINSEY DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINSEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-926-5700
Mailing Address - Street 1:17633 GUNN HWY STE 364
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1912
Mailing Address - Country:US
Mailing Address - Phone:813-926-5700
Mailing Address - Fax:813-926-7800
Practice Address - Street 1:610 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3336
Practice Address - Country:US
Practice Address - Phone:727-446-7578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty