Provider Demographics
NPI:1730689381
Name:HUNTER, KYLE (DPT)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 UNIVERSITY BLVD APT 106
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3057
Mailing Address - Country:US
Mailing Address - Phone:954-249-4619
Mailing Address - Fax:
Practice Address - Street 1:10050 SW INNOVATION WAY STE 201
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2117
Practice Address - Country:US
Practice Address - Phone:772-879-8700
Practice Address - Fax:772-879-8710
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist