Healthcare Provider Details

I. General information

NPI: 1477461366
Provider Name (Legal Business Name): KYLE SCHILLER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 60TH ST W STE B
BRADENTON FL
34209-5526
US

IV. Provider business mailing address

1701 CENTRAL AVE UNIT 106
ST PETERSBURG FL
33713-8916
US

V. Phone/Fax

Practice location:
  • Phone: 941-794-3344
  • Fax:
Mailing address:
  • Phone: 815-914-0310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16023
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: