Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME0061940 | FL |
NPI | 1164461398 |
---|---|
Provider Name | Dr. Edward S Kelley |
First Address | Naples, FL 34102-5616 |
Second Address | Naples, FL 34102-5616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 19/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F28362 | (02) | FL |