Individual
KYLA FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 W SEMINOLE BLVD, SANFORD, FL 32771-6743
(608) 397-4223
Mailing address
8701 W WATERTOWN PLANK RD, MILWAUKEE, WI 53226-3548
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
ME169827
FL
Other
Enumeration date
03/26/2018
Last updated
09/23/2024
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