Individual
KELLY PELAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10507 WILLOWBRAE DR, TAMPA, FL 33624-5223
(813) 967-6410
Mailing address
10507 WILLOWBRAE DR, TAMPA, FL 33624-5223
(813) 967-6410
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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