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General NPI Number Information
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NPI Number | 1417679762
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Entity Type | Individual
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Provider Name | KYLE JAMES OLEARY ARNP
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Gender | Male
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1442 NE 26TH ST
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City | WILTON MANORS
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State | FL
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Zip | 33305-1322
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Country | US
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Telephone | 954-391-7160
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Fax | 954-393-0811
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Provider Business Mailing Address
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Address Line | 1442 NE 26TH ST
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City | WILTON MANORS
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State | FL
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Zip | 33305-1322
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Country | US
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Telephone | 954-391-7160
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Fax | 954-393-0811
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 1245103449
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | 10D2317428
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 1003647587
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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License Number | 1245103349
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 1417679762
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 1003647587
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1003647587
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1245103349
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | JR56579000
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 1003647587
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License Number State | FL
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Taxonomy #11
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 1245103349
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License Number State | FL
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Taxonomy #12
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11021418
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License Number State | FL
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Taxonomy #13
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1245103349
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License Number State | FL
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Taxonomy #14
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1003647587
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License Number State | FL
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Taxonomy #15
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1245103349
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License Number State | FL
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