Kyla Fredrickson, MD
Surgery, Surgical Critical Care in Sanford, FL. Individual provider (NPI-1).
NPI number1417452012
StatusActive
Last updated in NPPESSep 23, 2024
Details
- NPI
- 1417452012
- Entity type
- Individual (NPI-1)
- Name
- Kyla Fredrickson
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 26, 2018
- Certification date
- Sep 23, 2024
- Last updated
- Sep 23, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0102X | Surgery, Surgical Critical Care | ME169827 | FL | Yes |
Practice location
1401 W Seminole BlvdSanford, FL 32771-6743
Phone 608-397-4223
Mailing address
8701 W Watertown Plank RdMilwaukee, WI 53226-3548
Other practice locations
8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Milwaukee, WI 53226-3548
Phone 414-955-4575
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