MEDICARE: KYLE JOSEPH MOYLES M.D.

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	207X00000X	Orthopaedic Surgery Physician	ME113873	FL
2	207XS0106X	Orthopaedic Hand Surgery Physician	ME113873	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	LB406	OTHER	FL	FL HFMG MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1779268	OTHER	FL	CIGNA
3	3469293	OTHER	FL	UNITED HEALTHCARE
4	LE632	OTHER	FL	FL HFMG
5	14QH3	OTHER	FL	FLORIDA BLUE PROVIDER ID
6	2514077	OTHER	FL	COVENTRY
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	9434935	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1679766133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE JOSEPH MOYLES M.D.

Provider Business Mailing Address
First Line	:	1310 W EAU GALLIE BLVD
Second Line	:	SUITE E
City	:	MELBOURNE
State	:	FL
Zip	:	32935-5300
Country	:	US
Telephone Number	:	321-500-4263
Fax Number	:	888-782-9622

Provider Business Practice Location Address
First Line	:	1310 W EAU GALLIE BLVD
Second Line	:	SUITE E
City	:	MELBOURNE
State	:	FL
Zip	:	32935-5300
Country	:	US
Telephone Number	:	321-500-4263
Fax Number	:	888-782-9622

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

Provider Enumeration Date	:	08/19/2007
Last Update Date	:	03/13/2020

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