Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Douglas Lille, PAC

Individual provider Physician Assistant · NPI 1679588750

Kevin Douglas Lille, PAC is a Physician Assistant in Port Charlotte, Florida. Qualified in 2000, 26 years ago. Practices with Spinal Health and Rehab of Punta Gorda, a 5-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
26
Licensed in
FL
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

21298 Olean Blvd Fawcett Memorial Hospital
Port Charlotte, FL 33952
Phone: (941) 627-6130
Fax: (941) 627-6146
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9101308 (FL)

Record details

NPI number1679588750
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJuly 29, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Spinal Health And Rehab Of Punta Gorda — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Port Charlotte