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Individual
WILLIAM B KELLER
Active
Individual
WILLIAM B KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 3132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12605910
CAQH
FL
01
—
54084
BC/BS
FL
01
—
PA 3132
PA LICENSE
FL
Enumeration date
02/07/2007
Last updated
02/10/2020
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