Individual
JOHN EDWARD KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1340 CITIZENS BLVD, LEESBURG, FL 34748-3924
(352) 435-7695
(352) 435-7453
Mailing address
PO BOX 1621, INVERNESS, FL 34451-1621
(352) 726-2947
(352) 435-7695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109928
FL
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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