Individual
DR. KYLE KUSUNOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
2142 NE 123RD ST, NORTH MIAMI, FL 33181-2902
(305) 967-8976
(305) 967-8863
Mailing address
3250 DAY AVE, MIAMI, FL 33133-5027
(760) 420-4890
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT29310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IE860Z
MEDICARE
FL
01
—
Y0R09
BLUE CROSS BLUE SHIELD OF FL.
FL
Enumeration date
12/06/2014
Last updated
08/31/2015
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