Individual
DR. KELLY J MEDWID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11750 SW 40TH STREET, MIAMI, FL 33175-3530
(305) 921-0961
Mailing address
1613 N. HARRISON PARKWAY, SUITE 200, MAILSTOP SH-9A, SUNRISE, FL 33323-2896
(954) 838-2955
(954) 616-3866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME123466
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2009
Last updated
07/14/2015
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