MEDICARE: DR. LYLE JAMES DENNIS 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	2084N0400X	Neurology Physician	77788	WI
2	2084N0400X	Neurology Physician	MA07078200	NJ
3	2084N0400X	Neurology Physician	205562	NY
4	2084V0102X	Vascular Neurology Physician	0101276333	VA
5	2084N0400X	Neurology Physician	ME161670	FL

General Provider Information

NPI Number	:	1598729220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYLE JAMES DENNIS MD

Provider Business Mailing Address
First Line	:	311 9TH ST N STE 110
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5886
Country	:	US
Telephone Number	:	239-624-4286
Fax Number	:	239-624-4201

Provider Business Practice Location Address
First Line	:	311 9TH ST N STE 110
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5886
Country	:	US
Telephone Number	:	239-624-4286
Fax Number	:	239-624-4201

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	03/05/2025

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