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General NPI Number Information
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NPI Number | 1689565566
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Entity Type | Individual
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Provider Name | DANIEL WILLIAM KELLY PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 222 S PENINSULA DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4422
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Country | US
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Telephone | 386-310-2160
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Fax | 386-310-2106
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Provider Business Mailing Address
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Address Line | 2549 MAITLAND CROSSING WAY APT 11308
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City | ORLANDO
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State | FL
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Zip | 32810-7111
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Country | US
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Telephone | 407-782-5300
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9120753
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License Number State | FL
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