Individual
DR. KELLIE ANN LONGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2402 UNIVERSITY PKWY, SUITE 106, BLDG. 1, SARASOTA, FL 34243
(941) 355-4411
(941) 355-5511
Mailing address
2402 UNIVERSITY PKWY, SUITE 106, BLDG. 1, SARASOTA, FL 34243
(941) 355-4411
(941) 355-5511
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P3920
TX
207R00000X
Internal Medicine Physician
ME97009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276635300
—
FL
05
—
347292001
—
TX
01
—
8EA296
BCBS
TX
Enumeration date
06/03/2006
Last updated
11/25/2015
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