Kelly, Kevin T

Kelly, Kevin T is an individual health care provider with primary practice located at 1397 Medical Park Blvd Suite 240, Wellington FL 33414-3186. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Kelly, Kevin T can be contacted via phone (561) 784-3788.

Contact Information

Primary practice address
1397 Medical Park Blvd Suite 240 Wellington FL 33414-3186
Phone: (561) 784-3788
Fax: (954) 229-3100
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME56260 Florida
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X ME56260 Florida

Profile Details

NPI number 1750323747
LBN Legal business name Kelly, Kevin T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 14th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750323747 NPPES
Florida Other 08555 BLUE CROSS BLUE SHIELD
Florida MEDICAID 055262300 BLUE CROSS BLUE SHIELD
Florida Other 230941 BLUE CROSS BLUE SHIELD
Florida Other 4360358 BLUE CROSS BLUE SHIELD

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