Individual
KELLYE MARIE KOUBEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1400 NW 12TH AVE, MIAMI, FL 33136-1003
(305) 243-5302
(305) 243-9161
Mailing address
1400 NW 12TH AVE, MIAMI, FL 33136-1003
(305) 243-5302
(305) 243-9161
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN110222802
FL
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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