Organization
I. BASIL KELLER, M.D.
Active
Parent organization
I. BASIL KELLER,M.D.
Other names
I. BASIL KELLER,M.D. NEUROLOGICAL SURGEON, CLINICAL NEUROSCIENCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
I. BASIL KELLER,M.D.
Authorized official
DR. IRVIN BASIL KELLER M.D. (SOLE PROPRIETOR)
(772) 569-9611
Entity
Organization
Contact information
Practice address
1850 37TH ST, SUITE C, VERO BEACH, FL 32960-4856
(772) 569-9611
(772) 569-9615
Mailing address
PO BOX 1449, VERO BEACH, FL 32961-1449
(772) 569-9611
(772) 569-9615
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
ME19360
FL
2084N0400X
Neurology Physician
ME19360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051314800
—
FL
01
—
1821036492
UNPI
FL
Enumeration date
03/12/2015
Last updated
03/07/2023
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