Provider Demographics
NPI:1609056811
Name:OBER, JAY KYLE (PHD, APRN)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:KYLE
Last Name:OBER
Suffix:
Gender:M
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S CONGRESS AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5802
Mailing Address - Country:US
Mailing Address - Phone:561-823-1020
Mailing Address - Fax:561-708-4003
Practice Address - Street 1:1325 S CONGRESS AVE STE 109
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5802
Practice Address - Country:US
Practice Address - Phone:561-823-1020
Practice Address - Fax:561-708-4003
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9235643363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care