Provider Demographics
NPI:1811480809
Name:FAILLE, KYLA (MD)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:FAILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:461 S NOVA RD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6138
Mailing Address - Country:US
Mailing Address - Phone:386-671-4337
Mailing Address - Fax:386-671-1127
Practice Address - Street 1:461 S NOVA RD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6138
Practice Address - Country:US
Practice Address - Phone:386-671-4337
Practice Address - Fax:386-481-6182
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN27048207Q00000X
FLME141908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine