Provider Demographics
NPI:1730543455
Name:BURTON, KYLE AARON (MD)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:AARON
Last Name:BURTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 VENETIAN COURT
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-8728
Mailing Address - Country:US
Mailing Address - Phone:239-596-9337
Mailing Address - Fax:239-596-9466
Practice Address - Street 1:23471 WALDEN CENTER DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-5016
Practice Address - Country:US
Practice Address - Phone:239-498-3376
Practice Address - Fax:239-498-3379
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.028058207R00000X
390200000X
OH35.139783207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program