Healthcare Provider Details

I. General information

NPI: 1184246837
Provider Name (Legal Business Name): BRIANA D KELLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SW 20TH CT
OCALA FL
34471-8885
US

IV. Provider business mailing address

1901 NW 55TH AVE
GAINESVILLE FL
32653-2146
US

V. Phone/Fax

Practice location:
  • Phone: 352-817-4004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: