MEDICARE: EMILY KELLY MD PLLC

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	208800000X	Urology Physician

General Provider Information

NPI Number	:	1316881733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMILY KELLY MD PLLC

Provider Business Mailing Address
First Line	:	PO BOX 510002
Second Line	:
City	:	MELBOURNE BEACH
State	:	FL
Zip	:	32951-0002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 E FEE AVE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-4612
Country	:	US
Telephone Number	:	585-313-3444
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. EMILY F KELLY
Credential	:	MD
Telephone Number	:	585-313-3444

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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