MEDICARE: KELSEY PARKS

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	207N00000X	Dermatology Physician	ME171423	FL

General Provider Information

NPI Number	:	1588240675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY PARKS

Provider Business Mailing Address
First Line	:	8625 COLLIER BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3601
Country	:	US
Telephone Number	:	239-732-0044
Fax Number	:	239-732-0094

Provider Business Practice Location Address
First Line	:	8625 COLLIER BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3601
Country	:	US
Telephone Number	:	239-732-0044
Fax Number	:	239-732-0094

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

Provider Enumeration Date	:	03/20/2021
Last Update Date	:	12/29/2025

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Directions to “ KELSEY PARKS ” Practice Location

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