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Individual

DR. KELLY C KOMATZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1519 SUMMER AVE, JUPITER, FL 33469-3119
(904) 428-9197
Mailing address
1519 SUMMER AVE, JUPITER, FL 33469-3119
(904) 428-9197

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME61036
FL
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
ME61036
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
257235401
FL
Enumeration date
05/17/2006
Last updated
11/17/2025
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