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NPI Code Detail

MEDICARE: KELLEY WINFREY DO

MEDICARE: KELLEY WINFREY DO
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
1207Q00000XFamily Medicine PhysicianOS11127FL

General Provider Information

NPI Number : 1386076321
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY WINFREY DO
Provider Business Mailing Address
First Line : 1135 LAKE AVE
Second Line :
City : CLERMONT
State : FL
Zip : 34711-3037
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1135 LAKE AVE
Second Line :
City : CLERMONT
State : FL
Zip : 34711-3037
Country : US
Telephone Number : 352-394-4035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2013
Last Update Date : 02/19/2024

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Directions to “ KELLEY WINFREY DO” Practice Location

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