MEDICARE: KYLER CAMPER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6385	FL

General Provider Information

NPI Number	:	1336915982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLER CAMPER OD

Provider Business Mailing Address
First Line	:	2227 CONWAY RD APT 1214
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8359
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 HOLDEN AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-1702
Country	:	US
Telephone Number	:	407-855-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2023
Last Update Date	:	11/27/2023

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Directions to “ KYLER CAMPER OD” Practice Location

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