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Individual

KYLE K. RUNNELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1058 TAMIAMI TRAIL, SUITE 108 - 128, SARASOTA, FL 34236-2416
(850) 714-4841
Mailing address
1058 TAMIAMI TRAIL, SUITE 108 - 128, SARASOTA, FL 34236-2416
(850) 714-4841

Taxonomy

Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
201837
LA
2084P0800X
Psychiatry Physician
Primary
ME149813
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21481
LA
Enumeration date
05/25/2007
Last updated
02/17/2022
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