Individual
RUSSELL LEE KYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRSS, CMMF
Contact information
Practice address
7207 N NEBRASKA AVE, TAMPA, FL 33604-4916
(813) 236-1182
Mailing address
6709 N RIVER BLVD, TAMPA, FL 33604-6027
(813) 520-2735
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/20/2017
Last updated
07/21/2022
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