Individual provider Active NPI

Kyle Fontaine

  • Student in an Organized Health Care Education/Training Program
  • Orlando, FL
National Provider Identifier
1538090543
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
UO11400 Issued in FL
Practice address
7727 Lake Underhill Rd
Orlando, FL 32822-8224
Phone
(407) 303-6413
NPI assigned
May 27, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UO11400 FL Primary

Addresses

Primary practice location

7727 Lake Underhill Rd
Orlando, FL 32822-8224

Mailing address

7727 Lake Underhill Rd
Orlando, FL 32822-8224
Phone (407) 303-6413

Other practice location 1

1611 NW 12th Ave Fl 33136
Miami, FL 33136-1096
Phone (407) 303-6413

Other practice location 2

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-6413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260617004246 FL Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 3779055074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
UO11400FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1538090543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7727 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228224",
            "telephone_number": "407-303-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228224",
            "telephone_number": "407-303-6413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave Fl 33136",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361096",
            "country_code": "US",
            "telephone_number": "407-303-6413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Rollins St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-303-6413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTAINE",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO11400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.