Individual
DR. KELLY D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1201 PIPER BLVD, SUITE 22, NAPLES, FL 34110-1380
(239) 734-3877
(239) 734-3879
Mailing address
PO BOX 61199, FORT MYERS, FL 33906-1199
(239) 418-0262
(239) 274-0773
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC 3770
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23001
BCBS NUMBER
FL
05
—
620851700
—
FL
01
—
OPC3770
MEDICAL LICENSE
FL
Enumeration date
09/20/2006
Last updated
12/06/2019
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