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NPI Code Detail

MEDICARE: DR. KELLY LYNN RAFF-ANUNCIATO D.O.

MEDICARE:  DR. KELLY LYNN RAFF-ANUNCIATO  D.O.
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
1207V00000XObstetrics & Gynecology Physician02740KY
2207V00000XObstetrics & Gynecology PhysicianOS7872FL

Other Identifiers

General Provider Information

NPI Number : 1760465926
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY LYNN RAFF-ANUNCIATO D.O.
Provider Business Mailing Address
First Line : 2550 W DR MARTIN LUTHER KING JR BLVD STE C
Second Line :
City : TAMPA
State : FL
Zip : 33607-6302
Country : US
Telephone Number : 813-684-2229
Fax Number : 813-413-0226
Provider Business Practice Location Address
First Line : 2550 W DR MARTIN LUTHER KING JR BLVD STE C
Second Line :
City : TAMPA
State : FL
Zip : 33607-6302
Country : US
Telephone Number : 813-684-2229
Fax Number : 813-413-0226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 01/28/2021

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Directions to “ DR. KELLY LYNN RAFF-ANUNCIATO D.O.” Practice Location

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