Individual
KYLE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 ALFRED DR, ORLANDO, FL 32810-5506
(855) 403-5312
Mailing address
PO BOX 570439, ORLANDO, FL 32857-0439
(855) 403-5312
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
05/07/2014
Last updated
05/08/2014
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