Healthcare Provider Details

I. General information

NPI: 1780597625
Provider Name (Legal Business Name): KELLEE LYNN HOLTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 SUNRISE PLAZA DR STE 6
CLERMONT FL
34714-6202
US

IV. Provider business mailing address

1480 HAMMOCK RIDGE RD APT 1205
CLERMONT FL
34711-6378
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-9341
  • Fax:
Mailing address:
  • Phone: 772-584-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number13716
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: