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General NPI Number Information
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NPI Number | 1679369177
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Entity Type | Individual
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Provider Name | KYLE EVAN LONGHOFER OTR/L
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Gender | Male
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 7470 SW 60TH AVE
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City | OCALA
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State | FL
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Zip | 34476-6428
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Country | US
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Telephone | 352-873-3058
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Fax |
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Provider Business Mailing Address
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Address Line | 10401 WOODLAND HILLS CT
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City | HOWEY IN THE HILLS
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State | FL
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Zip | 34737-4112
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Country | US
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Telephone | 321-514-3126
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT26070
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License Number State | FL
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