Individual
KYLE MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1818 HARDEN BLVD, SUITE 120, LAKELAND, FL 33803-1812
(239) 278-1155
(239) 278-1159
Mailing address
1818 HARDEN BLVD, SUITE 120, LAKELAND, FL 33803-1812
(239) 278-1155
(239) 278-1159
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106424
FL
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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