Healthcare Provider Details

I. General information

NPI: 1033041017
Provider Name (Legal Business Name): MILENA BARBARA KELLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 10TH CT.
VERO BEACH FL
32960
US

IV. Provider business mailing address

1000 36TH ST
VERO BEACH FL
32960-4862
US

V. Phone/Fax

Practice location:
  • Phone: 772-563-4611
  • Fax: 772-794-1487
Mailing address:
  • Phone: 772-563-4611
  • Fax: 772-794-1487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPS40131
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: