Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO3907 | FL |
Y | 222Z00000X | Podiatrist | PO3907 | FL |
N | 213EP0504X | Public Medicine | PO3907 | FL |
N | 213EP1101X | Primary Podiatric Medicine | PO3097 | FL |
N | 111NR0200X | Radiology | PO3907 | FL |
N | 213ER0200X | Radiology | PO3907 | FL |
N | 2081S0010X | Sports Medicine | PO3907 | FL |
N | 213ES0000X | Sports Medicine | PO3907 | FL |
N | 213ES0103X | Foot & Ankle Surgery | PO3907 | FL |
N | 213ES0131X | Foot Surgery | PO3907 | FL |
NPI | 1730476649 |
---|---|
Provider Name | Kelli Marie Ashe |
First Address | Boca Raton, FL 33428-1781 |
Second Address | Boca Raton, FL 33428-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 17/03/2018 |