Provider Demographics
NPI:1730504879
Name:MIKALS, KYLE (MD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:MIKALS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PSC 475 BOX 1
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96350-1200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5011 GATE PARKWAY BLDG 100
Practice Address - Street 2:SUITE 100 PMB 1063
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:904-584-4944
Practice Address - Fax:904-839-7113
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101260378207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine