Healthcare Provider Details

I. General information

NPI: 1023636586
Provider Name (Legal Business Name): KELLY MARIE LAFOND-KITAIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27810 SUMMERGATE BLVD
WESLEY CHAPEL FL
33544-6919
US

IV. Provider business mailing address

27810 SUMMERGATE BLVD
WESLEY CHAPEL FL
33544-6919
US

V. Phone/Fax

Practice location:
  • Phone: 813-388-2948
  • Fax: 813-388-6827
Mailing address:
  • Phone: 813-388-2948
  • Fax: 813-388-6827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11007591
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: