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General NPI Number Information
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NPI Number | 1366853731
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Entity Type | Individual
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Provider Name | KYLE ANDREW DALLAS DEN BESTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 105 BONNIE LOCH CT STE A
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City | ORLANDO
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State | FL
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Zip | 32806-2909
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Country | US
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Telephone | 407-245-3636
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Fax | 407-245-3637
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Provider Business Mailing Address
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Address Line | 105 BONNIE LOCH CT STE A
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City | ORLANDO
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State | FL
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Zip | 32806-2909
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Country | US
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Telephone | 407-245-3636
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Fax | 407-245-3636
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME139689
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License Number State | FL
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