Individual
BRIDGET KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7009 DR PHILLIPS BLVD STE 100, ORLANDO, FL 32819-5122
(407) 218-4550
Mailing address
5680 OAK LAKE TRL, OVIEDO, FL 32765-7368
(412) 608-2380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107290
FL
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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