Provider Demographics
NPI:1760731889
Name:LYLE, JUNE RENEE (SURGICAL TECH (NCCT))
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:RENEE
Last Name:LYLE
Suffix:
Gender:F
Credentials:SURGICAL TECH (NCCT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1405 CENTERVILLE RD
Mailing Address - Street 2:SUITE 4200
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-877-3549
Mailing Address - Fax:850-671-2971
Practice Address - Street 1:1405 CENTERVILLE RD
Practice Address - Street 2:SUITE 4200
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-877-3549
Practice Address - Fax:850-671-2971
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant