MEDICARE: DR. KYE C PAHK MD

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	208800000X	Urology Physician	ME0024486	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28050	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1558357657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYE C PAHK MD

Provider Business Mailing Address
First Line	:	6801 US 27 N
Second Line	:	SUITE C-2
City	:	SEBRING
State	:	FL
Zip	:	33870-1000
Country	:	US
Telephone Number	:	863-382-0333
Fax Number	:	863-382-8777

Provider Business Practice Location Address
First Line	:	6801 US 27 N
Second Line	:	SUITE C-2
City	:	SEBRING
State	:	FL
Zip	:	33870-1000
Country	:	US
Telephone Number	:	863-382-0333
Fax Number	:	863-382-8777

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. KYE C PAHK MD” Practice Location

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