Waisanen, Kyle Matthew

Waisanen, Kyle Matthew is an individual health care provider with primary practice located at 2400 Harbor Blvd Ste 8 , Port Charlotte FL 33952-5038. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Waisanen, Kyle Matthew can be contacted via phone (941) 766-5070.

Contact Information

Primary practice address
2400 Harbor Blvd Ste 8 Port Charlotte FL 33952-5038
Phone: (941) 766-5070
Fax: (941) 766-5071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X ME162353 Florida
Allopathic & Osteopathic Physicians / Urology 208800000X 4301513351 Michigan

Profile Details

NPI number 1033616909
LBN Legal business name Waisanen, Kyle Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2018
Last updated Sep 14th, 2026 - about last month

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033616909 NPPES
Florida MEDICAID 118384100
Florida Other 4301513351

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