Dillon Michael Kelly, PA-C
Physician Assistant in Orlando, FL. Individual provider (NPI-1).
NPI number1366041402
StatusActive
Last updated in NPPESDec 23, 2022
Details
- NPI
- 1366041402
- Entity type
- Individual (NPI-1)
- Name
- Dillon Michael Kelly
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 20, 2020
- Certification date
- Dec 23, 2022
- Last updated
- Dec 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9115478 | FL | Yes |
| 363A00000X | Physician Assistant | 324554 | LA |
Practice location
9400 Turkey Lake RdOrlando, FL 32819-8001
Phone 407-351-8587
Mailing address
9400 Turkey Lake RdOrlando, FL 32819-8001
Phone 407-351-8587
Other practice locations
1214 Coolidge St.
Lafayette, LA 70503-2621
Lafayette, LA 70503-2621
Phone 337-289-7991
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