Kylie Jae Lavine

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTT40277 Issued in FL

Practice address

200 Southpark Blvd Ste 102
St Augustine, FL 32086-3129

Phone

(774) 670-8023

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1417641010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 GULF SHORE BLVD N APT N8",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033609",
            "telephone_number": "774-670-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTHPARK BLVD STE 102",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863129",
            "telephone_number": "774-670-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "KYLIE",
        "middle_name": "JAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT40277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Lassiter
• Launch Communication Therapy Group, LLC
• Laurence M Matthews MD LLC
• Nicole Lauver
• Teri Ann Lavenbarg, ARNP-NP
• Brian J Law, MPH
• Sam Lawless, MSW
• Curtis L Lawrence, LCSW
• Amy Layh, LMHC
• Laurence Layne, LMT

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.