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NPI Code Detail

MEDICARE: KYLE ROBERTS

MEDICARE:   KYLE  ROBERTS
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
1171100000XAcupuncturist4376FL

General Provider Information

NPI Number : 1528884574
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE ROBERTS
Provider Business Mailing Address
First Line : 1280 INGLESIDE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-7731
Country : US
Telephone Number : 904-993-4155
Fax Number :
Provider Business Practice Location Address
First Line : 2105 PARK ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-3871
Country : US
Telephone Number : 904-993-4155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2024
Last Update Date : 11/25/2024

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Directions to “ KYLE ROBERTS ” Practice Location

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