Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3212122 | FL |
NPI | 1003050295 |
---|---|
Provider Name | Janine Marie Kyte |
First Address | Orlando, FL 32822-1722 |
Second Address | Orlando, FL 32822-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2009 |
Last Update Date | 30/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001301400 | (05) | FL |
01283484 | AMERIGROUP (01) | FL |
515431 | WELLCARE (01) | FL |