# KELLY ANDERSON OD PA

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

## Provider details

- **NPI number:** 1801094933
- **Authorized official:** DR. KELLY ANDERSON OD (PRESIDENT)
- **Authorized official phone:** (239) 297-2883

## Contact information

- **Practice address:** 15495 TAMIAMI TRL N, SUITE 124, NAPLES, FL 34110-6206
- **Practice address phone:** (239) 593-4801
- **Practice address fax:** (239) 593-3019
- **Mailing address:** 13300 S CLEVELAND AVE STE 56, SUITE 153, FORT MYERS, FL 33907-3871
- **Mailing address phone:** (239) 297-2883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WC0802X | Corneal and Contact Management Optometrist | OPC 3770 | FL | Yes |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 07/26/2007