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NPI Code Detail

MEDICARE: DAVID KELLY

MEDICARE: DAVID KELLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1184563942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID KELLY
Provider Business Mailing Address
First Line : 1239 E NEWPORT CENTER DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33442-7711
Country : US
Telephone Number : 754-341-2745
Fax Number :
Provider Business Practice Location Address
First Line : 1239 E NEWPORT CENTER DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33442-7711
Country : US
Telephone Number : 754-341-2745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 03/26/2026

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Directions to “ DAVID KELLY ” Practice Location

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