Provider Demographics
NPI:1821434762
Name:DOWNING, KYLE A
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:A
Last Name:DOWNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 W 76TH ST APT 104
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1208
Mailing Address - Country:US
Mailing Address - Phone:913-426-7851
Mailing Address - Fax:
Practice Address - Street 1:2626 CYPRESS RIDGE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6315
Practice Address - Country:US
Practice Address - Phone:813-991-7193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
FLPT33239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No172V00000XOther Service ProvidersCommunity Health Worker