Individual
MRS. KELLY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 VIA BELLA BLVD STE 102, LAND O LAKES, FL 34639-5429
(813) 712-5718
(813) 355-5029
Mailing address
38135 MARKET SQUARE DR, ZEPHYRHILLS, FL 33542-7505
(352) 567-0188
(813) 355-5101
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
025795
NY
363AM0700X
Medical Physician Assistant
025795
NY
363AM0700X
Medical Physician Assistant
Primary
PA9117316
FL
Other
Enumeration date
04/03/2019
Last updated
01/17/2024
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