Individual
DR. JUSTIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
661 E ALTAMONTE DR STE 220, ALTAMONTE SPRINGS, FL 32701-5102
(407) 303-5191
(407) 303-5193
Mailing address
661 E ALTAMONTE DR STE 220, ALTAMONTE SPRINGS, FL 32701-5102
(407) 303-5191
(407) 303-5193
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
ME134463
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN22550
FL
Other
Enumeration date
07/20/2016
Last updated
12/06/2017
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