1932338340 NPI number — KYLE FURBEE, D.C., P.A.

Table of content: (NPI 1932338340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932338340 NPI number — KYLE FURBEE, D.C., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KYLE FURBEE, D.C., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932338340
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 ALLAMANDA DR
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
LAKELAND
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33803-2928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-802-8855
Provider Business Mailing Address Fax Number:
863-802-8850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 ALLAMANDA DR
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
LAKELAND
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33803-2928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-802-8855
Provider Business Practice Location Address Fax Number:
863-802-8850
Provider Enumeration Date:
07/07/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FURBEE
Authorized Official First Name:
KYLE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
863-802-8855

Provider Taxonomy Codes

  • Taxonomy code: 111NN1001X , with the licence number:  CH0006326 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)