# KELLY A. PONCHERI DPM PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Foot & Ankle Institute of Central Florida
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619269362
- **Authorized official:** KELLY PONCHERI DPM (OWNER)
- **Authorized official phone:** (239) 278-1155

## Contact information

- **Practice address:** 4692 EXPLORATION AVE, LAKELAND, FL 33812-4107
- **Practice address phone:** (239) 278-1155
- **Mailing address:** 4692 EXPLORATION AVE, LAKELAND, FL 33812-4107
- **Mailing address phone:** (239) 278-1155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO 3478 | FL | Yes |

## Other

- **Enumeration date:** 05/12/2011
- **Last updated:** 07/07/2011