Healthcare Provider Details

I. General information

NPI: 1285551754
Provider Name (Legal Business Name): CECILE WILSONKELLY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13613 US HIGHWAY 1
SEBASTIAN FL
32958-3230
US

IV. Provider business mailing address

13613 US HIGHWAY 1
SEBASTIAN FL
32958-3230
US

V. Phone/Fax

Practice location:
  • Phone: 772-589-6477
  • Fax: 772-589-9536
Mailing address:
  • Phone: 772-589-6477
  • Fax: 772-589-9536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS38467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: