Individual
MARK JOSEPH KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8925 COLONIAL CENTER DR STE 2001, FORT MYERS, FL 33905-7813
(239) 396-8930
(239) 396-8932
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 396-8930
(239) 396-8932
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
G55252
CA
208800000X
Urology Physician
Primary
ME157212
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120219800
—
FL
01
—
1598827826
INCORPORATION NPI
—
Enumeration date
11/20/2006
Last updated
09/10/2025
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