MEDICARE: KELLY O'MARA ARONOFF DNP-CRNA

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	367500000X	Certified Registered Nurse Anesthetist	R208210	MD
2	367500000X	Certified Registered Nurse Anesthetist	APRN11012047	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

General Provider Information

NPI Number	:	1396372538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY O'MARA ARONOFF DNP-CRNA

Provider Business Mailing Address
First Line	:	4836 19TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33714-3306
Country	:	US
Telephone Number	:	443-629-8722
Fax Number	:

Provider Business Practice Location Address
First Line	:	3835 39TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33714-4411
Country	:	US
Telephone Number	:	443-622-2767
Fax Number	:

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

Provider Enumeration Date	:	03/26/2020
Last Update Date	:	05/24/2024

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