Individual
JOHN KYLE PROFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0111
Mailing address
1600 SW ARCHER RD, BOX 100108, GAINESVILLE, FL 32610-0108
(352) 273-5670
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9111400
FL
363A00000X
Physician Assistant
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100738100
—
FL
Enumeration date
06/25/2018
Last updated
06/05/2019
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