# KEVIN T KELLY M D PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538363742
- **Authorized official:** DR. KEVIN THOMAS KELLY M.D. (CEO)
- **Authorized official phone:** (561) 628-9969

## Contact information

- **Practice address:** 1397 MEDICAL PARK BLVD, SUITE 240, WELLINGTON, FL 33414
- **Practice address phone:** (561) 784-3788
- **Mailing address:** 1397 MEDICAL PARK BLVD, SUITE 240, WELLINGTON, FL 33414
- **Mailing address phone:** (561) 784-3788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME0056260 | FL | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 08/22/2020