Lawrence D Kelley
Family Medicine in Longwood, FL. Organization (NPI-2).
NPI number1639166317
StatusActive
Last updated in NPPESOct 23, 2008
Details
- NPI
- 1639166317
- Entity type
- Organization (NPI-2)
- Legal business name
- Lawrence D Kelley
- Organization subpart
- No
- Enumeration date
- Sep 29, 2005
- Last updated
- Oct 23, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
587 E State Road 434Suite 1071
Longwood, FL 32750-5201
Phone 407-767-8500 · Fax 407-767-6999
Mailing address
587 E State Road 434Suite 1071
Longwood, FL 32750-5201
Phone 407-767-8500 · Fax 407-767-6999
Authorized official
Lawrence Delano Kelley
Owner
4077678500
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