Provider Demographics
NPI:1891785770
Name:FURBEE, KYLE ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ERIC
Last Name:FURBEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ALLAMANDA DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2980
Mailing Address - Country:US
Mailing Address - Phone:863-802-8855
Mailing Address - Fax:863-802-8850
Practice Address - Street 1:200 ALLAMANDA DR STE A
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2980
Practice Address - Country:US
Practice Address - Phone:863-802-8855
Practice Address - Fax:863-802-8850
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU40945Medicare UPIN
FL22873Medicare PIN