Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME142276 | FL |
Y | 208600000X | Surgeon | ME142276 | FL |
N | 208200000X | Surgeon | MT 182598 | PA |
N | 208600000X | Surgeon | MT 182598 | PA |
N | 208200000X | Surgeon | MT182598 | PA |
N | 208600000X | Surgeon | MT182598 | PA |
N | 2086S0105X | Surgery of the Hand | 076607 | GA |
N | 2086S0105X | Surgery of the Hand | N7546 | TX |
NPI | 1679766943 |
---|---|
Provider Name | Mr. Kyle A Herron |
First Address | Daytona Beach, FL 32117-7207 |
Second Address | Daytona Beach, FL 32117-7207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 18/08/2020 |