Provider Demographics
NPI:1629077342
Name:KYLE, KEVIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:C
Last Name:KYLE
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 1:10225 ULMERTON RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3522
Mailing Address - Country:US
Mailing Address - Phone:727-585-7408
Mailing Address - Fax:313-838-6322
Practice Address - Street 1:2812 SAINT MARKS DR
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-1926
Practice Address - Country:US
Practice Address - Phone:813-665-1658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2024-02-21
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FL119987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine