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NPI Code Detail

MEDICARE: KYLE IANNOTTI

MEDICARE:   KYLE  IANNOTTI
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
1183500000XPharmacist0202210758VA

General Provider Information

NPI Number : 1528335874
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE IANNOTTI
Provider Business Mailing Address
First Line : 901 HIDDEN VALLEY DR
Second Line : 5303
City : ROUND ROCK
State : TX
Zip : 78665-1394
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 36000 CARL R DARNALL ARMY MEDICAL CENTER
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5005
Country : US
Telephone Number : 254-288-8801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2011
Last Update Date : 11/30/2011

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Directions to “ KYLE IANNOTTI ” Practice Location

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