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General NPI Number Information
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NPI Number | 1487465852
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Entity Type | Individual
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Provider Name | MR. DAVID KELLY
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Gender | Male
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 150 HASE RD
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City | PENSACOLA
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State | FL
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Zip | 32508-1051
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Country | US
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Telephone | 850-436-4212
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Fax |
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Provider Business Mailing Address
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Address Line | 7474 DECK LN
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City | PENSACOLA
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State | FL
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Zip | 32526-8593
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Country | US
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Telephone | 850-512-9494
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | EMT564404
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License Number State | FL
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