Individual
DAVID K KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
401 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7322
(407) 667-0444
(407) 667-4338
Mailing address
291 SOUTHHALL LN, MAITLAND, FL 32751-7274
(407) 667-0444
(407) 667-4338
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP2572842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G2004Y
BCBS
FL
Enumeration date
10/31/2005
Last updated
07/08/2007
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