Tashiana Kelly Valid NPI
Individual provider · Point of Service · Jacksonville, FL
- NPI
- 1528666146
- Type
- Individual (Type 1)
- Primary specialty
- Point of Service
- Specialty group
- Managed Care Organizations
- Taxonomy code
- 305S00000X
- License number
- W689477 (FL)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2020-10-15
- Last updated
- 2020-10-15
Practice location
2611 University Blvd N Apt C203
Jacksonville, FL 32211-3287
(904) 248-2208