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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326024902 NPPES
Florida Other IBWUZ FLORIDA BLUE
Florida MEDICAID 016279500 FLORIDA BLUE

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