Healthcare Provider Details
I. General information
NPI: 1558949842
Provider Name (Legal Business Name): KYLIE LYNN ALBERTS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2021
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US
IV. Provider business mailing address
5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US
V. Phone/Fax
- Phone: 561-766-1300
- Fax: 561-257-3477
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | OS20662 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: