Provider Demographics
NPI:1871279513
Name:BARTO, KYLIE ERICA (OD)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:ERICA
Last Name:BARTO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SANDPIPER AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2918
Mailing Address - Country:US
Mailing Address - Phone:330-324-7009
Mailing Address - Fax:
Practice Address - Street 1:3893 MILITARY TRL STE 4
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2936
Practice Address - Country:US
Practice Address - Phone:561-429-8753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC006274152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist