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Organization
KYLE CLINIC
Active
Organization
KYLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY LAWRENCE (OFFICE MANAGER)
(904) 280-8657
Entity
Organization
Contact information
Practice address
1110 A1A N STE 101, PONTE VEDRA BEACH, FL 32082-4071
(904) 280-8657
(904) 280-8659
Mailing address
1110 A1A N STE 101, PONTE VEDRA BEACH, FL 32082-4071
(904) 280-8657
(904) 280-8659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME83612
FL
Other
Enumeration date
12/08/2006
Last updated
08/22/2020
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