Individual
KYLE PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4215 BURNS RD STE 100, PALM BEACH GARDENS, FL 33410-4627
(561) 694-7776
(561) 694-3099
Mailing address
4215 BURNS RD STE 200, PALM BEACH GARDENS, FL 33410-4625
(561) 694-7776
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
ME155351
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2016
Last updated
05/08/2023
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