Individual
KYLE ALEXANDER WUTHRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
OS19078
FL
2084N0400X
Neurology Physician
Primary
OS19078
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115011500
—
FL
Enumeration date
03/26/2017
Last updated
08/10/2022
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