King, Kelly Ennix

King, Kelly Ennix is an individual health care provider with primary practice located at 935 Oakfield Dr , Brandon FL 33511-4935. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. King, Kelly Ennix can be contacted via phone (813) 651-3492.

Contact Information

Primary practice address
935 Oakfield Dr Brandon FL 33511-4935
Phone: (813) 651-3492
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME116572 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A83650 California
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X ME116572 Florida
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X A83650 California

Profile Details

NPI number 1114998606
LBN Legal business name King, Kelly Ennix
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated May 3rd, 2023 - about 3 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 1114998606 NPPES
California MEDICAID 009385100
California MEDICAID 009385100

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