Organization
I. BASIL KELLER, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRVIN BASIL KELLER M.D. (PRESIDENT)
(772) 569-6444
Entity
Organization
Contact information
Practice address
3790 7TH TER, STE., 201, VERO BEACH, FL 32960-6552
(772) 569-9611
(772) 569-9615
Mailing address
PO BOX 1449, VERO BEACH, FL 32961-1449
(772) 569-9611
(772) 569-9615
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279265600
—
FL
Enumeration date
01/26/2007
Last updated
09/23/2008
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