Individual
MRS. KELLI K THOMAZIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
773 STIRLING CENTER PL, LAKE MARY, FL 32746-4856
(407) 977-4130
(407) 977-4139
Mailing address
773 STIRLING CENTER PL, LAKE MARY, FL 32746-4856
(407) 977-4130
(407) 977-4139
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1029
NE
363AM0700X
Medical Physician Assistant
1029
NE
363AS0400X
Surgical Physician Assistant
1029
NE
363AS0400X
Surgical Physician Assistant
Primary
PA9113657
FL
Other
Enumeration date
05/19/2006
Last updated
11/07/2024
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