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General NPI Number Information
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NPI Number | 1194164517
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Entity Type | Individual
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Provider Name | KYLE JARROD LINSEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 610 LAKEVIEW RD
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City | CLEARWATER
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State | FL
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Zip | 33756-3336
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Country | US
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Telephone | 727-446-7578
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Fax |
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Provider Business Mailing Address
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Address Line | 13930 SHADY SHORES DR
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City | TAMPA
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State | FL
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Zip | 33613-1900
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Country | US
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Telephone | 813-382-7022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS12404
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS016632
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS12404
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License Number State | FL
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