Healthcare Provider Details

I. General information

NPI: 1871279513
Provider Name (Legal Business Name): KYLIE ERICA BARTO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5165 S STATE ROAD 7
LAKE WORTH FL
33449-5456
US

IV. Provider business mailing address

5165 S STATE ROAD 7
LAKE WORTH FL
33449-5456
US

V. Phone/Fax

Practice location:
  • Phone: 330-324-7009
  • Fax:
Mailing address:
  • Phone: 330-324-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC006274
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: