MEDICARE: MRS. KELLY MARIE MULLIKIN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9109308	FL
2	363A00000X	Physician Assistant
3	363AM0700X	Medical Physician Assistant	PA9109308	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225495526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY MARIE MULLIKIN PA-C

Provider Business Mailing Address
First Line	:	2939 ALT 19 # MS 702
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1928
Country	:	US
Telephone Number	:	727-786-5058
Fax Number	:	813-635-2639

Provider Business Practice Location Address
First Line	:	2939 ALT 19 # MS 702
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1928
Country	:	US
Telephone Number	:	727-786-5058
Fax Number	:	813-635-2639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	08/17/2023

Similar Medicare Providers

1982657672 — DR. LOUISE OYCO SANTOS MD
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-2298
Practice Fax: 813-635-7944

1215270111 — LUPITA CATRINA GALLARDO M.D.
Practice Location Address:

2931 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-2298
Practice Fax: 813-635-7944

1821422783 — DR. MATTHEW R. IRVIN M.D.
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-2295
Practice Fax: 813-635-7944

1770153579 — BAYCARE MEDICAL GROUP INC
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-547-8425
Practice Fax: 813-635-2699

1952032120 — DR. LINDSEY ANN CRNALIC DMD
Practice Location Address:

2939 PALM HARBOR BLVD
PALM HARBOR, FL
34683-1928

Practice Phone: 727-348-0830
Practice Fax:

1518749944 — CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-6521
Practice Fax:

Directions to “ MRS. KELLY MARIE MULLIKIN PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.