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Individual

KELLY DONATELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3949 EVANS AVE, STE 102, FORT MYERS, FL 33901-9335
(239) 939-2622
(239) 939-0151
Mailing address
3209 ANTICA ST, FORT MYERS, FL 33905-1503
(239) 939-2622
(239) 939-0151

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9237289
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BLUE CROSS
G3949
FL
01
RAILROAD MEDICARE
P00277773
FL
Enumeration date
02/15/2006
Last updated
08/03/2007
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