Individual
BETTY CHENEY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1755 W HIBISCUS BLVD, MELBOURNE, FL 32901-2616
(321) 724-5437
(321) 724-5570
Mailing address
134 S WOODS DR, ROCKLEDGE, FL 32955-3262
(321) 636-3066
(321) 636-2545
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME135059
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024240500
—
FL
Enumeration date
07/01/2015
Last updated
07/01/2019
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