Individual
KYLE BLASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1381 S PATRICK DR, PATRICK AFB, FL 32925-3606
(321) 494-8241
Mailing address
1381 S PATRICK DR, PATRICK AFB, FL 32925-3606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.015266
OH
208M00000X
Hospitalist Physician
34.015266
OH
208M00000X
Hospitalist Physician
Primary
OS21384
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300207
—
OH
05
—
124644000
—
FL
01
—
T0769
MEDICARE HFMG
FL
Enumeration date
01/29/2018
Last updated
05/16/2025
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