Provider Demographics
NPI:1881916013
Name:MYERS, KYLE (OTR/L)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 10TH ST
Mailing Address - Street 2:307
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5318
Mailing Address - Country:US
Mailing Address - Phone:954-961-9522
Mailing Address - Fax:
Practice Address - Street 1:2480 N PARK RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3744
Practice Address - Country:US
Practice Address - Phone:954-961-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9546225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist