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NPI Code Detail

MEDICARE: KELLY ANN PERRY

MEDICARE:   KELLY ANN PERRY
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
1235Z00000XSpeech-Language Pathologist16714FL

General Provider Information

NPI Number : 1932677267
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ANN PERRY
Provider Business Mailing Address
First Line : 2107 W KYRA DR
Second Line :
City : TAMPA
State : FL
Zip : 33612-5053
Country : US
Telephone Number : 727-421-6698
Fax Number :
Provider Business Practice Location Address
First Line : 2107 W KYRA DR
Second Line :
City : TAMPA
State : FL
Zip : 33612-5053
Country : US
Telephone Number : 727-421-6698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2018
Last Update Date : 11/05/2018

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Directions to “ KELLY ANN PERRY ” Practice Location

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