Individual
CYNTHIA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11181 HEALTH PARK BLVD, SUITE 11181, NAPLES, FL 34110-5738
(239) 594-9075
(239) 594-9263
Mailing address
11181 HEALTH PARK BLVD, SUITE 11181, NAPLES, FL 34110-5738
(239) 594-9075
(239) 594-9263
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 9101444
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290886700
—
FL
01
—
970018589
RAILROAD MEDICARE
—
Enumeration date
07/07/2006
Last updated
03/06/2012
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