Wyatt, Kimberly Sue
Wyatt, Kimberly Sue is an individual health care provider with primary practice located at 509 Se Riverside Dr Ste 303 , Stuart FL 34994-2579. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is her primary health care specialty. Wyatt, Kimberly Sue can be contacted via phone (772) 283-9111.Contact Information
Primary practice address
509 Se Riverside Dr Ste 303
Stuart FL 34994-2579
Phone: (772) 283-9111
Fax: (772) 781-2785
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME121614 | Florida |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | ME121614 | Florida |
Profile Details
| NPI number | 1326024902 |
|---|---|
| LBN Legal business name | Wyatt, Kimberly Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2005 |
| Last updated | Oct 13th, 2020 - about 4 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326024902 | NPPES |
| Florida | Other | IBWUZ | FLORIDA BLUE |
| Florida | MEDICAID | 016279500 | FLORIDA BLUE |
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