MEDICARE: JAY KYLE OBER PHD, APRN

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	363LA2100X	Acute Care Nurse Practitioner	9235643	FL
2	363LA2200X	Adult Health Nurse Practitioner	9235643	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609056811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY KYLE OBER PHD, APRN

Provider Business Mailing Address
First Line	:	1325 S CONGRESS AVE STE 109
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5802
Country	:	US
Telephone Number	:	561-823-1020
Fax Number	:	561-708-4003

Provider Business Practice Location Address
First Line	:	1325 S CONGRESS AVE STE 109
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5802
Country	:	US
Telephone Number	:	561-823-1020
Fax Number	:	561-708-4003

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

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	03/17/2024

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