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NPI Code Detail

MEDICARE: WILLIAM KELLEY

MEDICARE: WILLIAM KELLEY
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
1225100000XPhysical Therapist31555FL

General Provider Information

NPI Number : 1831542836
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM KELLEY
Provider Business Mailing Address
First Line : 1115 E SUNRISE BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-2809
Country : US
Telephone Number : 954-247-4929
Fax Number :
Provider Business Practice Location Address
First Line : 1115 E SUNRISE BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-2809
Country : US
Telephone Number : 954-247-4929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2016
Last Update Date : 01/26/2022

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Directions to “ WILLIAM KELLEY ” Practice Location

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