Individual
KELLY TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
627 8TH ST, CLERMONT, FL 34711-2159
(352) 243-9341
(352) 242-8766
Mailing address
12424 LAKE VALLEY DR, CLERMONT, FL 34711-6712
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT31476
FL
Other
Enumeration date
08/18/2017
Last updated
02/23/2021
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