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General NPI Number Information
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NPI Number | 1427647403
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Entity Type | Individual
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Provider Name | ARALY ALEXIS KELLY FNP
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Gender | Female
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1951 SW 172ND AVE STE 205
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City | MIRAMAR
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State | FL
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Zip | 33029-5613
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Country | US
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Telephone | 954-447-5206
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 SW 172ND AVE STE 314
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City | MIRAMAR
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State | FL
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Zip | 33029-5614
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Country | US
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Telephone | 954-444-7520
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12200392
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License Number State | FL
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