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General NPI Number Information
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NPI Number | 1184981623
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Entity Type | Individual
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Provider Name | KELLY CASON DRIVER DO
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Gender | Female
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 119 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-916-0674
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Fax | 813-916-2910
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Provider Business Mailing Address
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Address Line | 501 6TH AVE S
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4634
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Country | US
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Telephone | 727-767-4313
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Fax | 727-767-4391
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | OS13319
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License Number State | FL
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