Individual
KYLE LENEWEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5151 N 9TH AVE # 305, PENSACOLA, FL 32504-8721
(850) 416-6159
Mailing address
1125 SANSOM ST APT 517, PHILADELPHIA, PA 19107-4864
(727) 224-2059
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
OS16687
FL
390200000X
Student in an Organized Health Care Education/Training Program
UO3919
FL
Other
Enumeration date
04/14/2015
Last updated
10/20/2020
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