Individual
BRIAN RICHARD KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6307
(813) 870-4000
Mailing address
2502 W SAINT ISABEL ST, TAMPA, FL 33607-6318
(813) 874-5707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9117340
FL
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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