Individual
MARK JOSEPH KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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