MRS. TRACY ANN KELLY (NPI# 1194949388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194949388 |
| Entity Type | Individual |
| Full Name | MRS. TRACY ANN KELLY |
| Other Name | MS. TRACY ANN BEVERLEY |
| Credential | PA |
| Practice Address |
3000 Sw 148th Ave Suite 200 Miramar FL 33027-4169 |
| Practice Telephone | 7032449469 |
| Mailing Telephone | 7032449469 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246Z00000X | Specialist/Technologist, Other | 012000974 | VA | Technologists, Technicians & Other Technical Service Providers |
| N | 363A00000X | Physician Assistant | 0110003365 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | PA9105943 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9105943 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1975 Glenn Mitchell Dr Ste 200, Virginia Beach, VA 234560167 | 7573213300 | 7573213330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982948725 | Tracy Susan Kelly | Counselor | 505 S Arlington Ave Ste 212-d, Reno, NV 89509-1527 | 2012-11-17 |
| 1942851308 | Tracy Kelly | Behavior Technician | 1901 S Main St, Keller, TX 76248-5120 | 2019-09-26 |
| 1558630384 | Tracy L Kelly | Social Worker | 50 Woodbridge Ave, Chatham, NY 12037-1317 | 2011-12-23 |
| 1891858668 | Tracy Kelly | Pediatrics | 205 Sage Rd, Suite 100, Chapel Hill, NC 27514-6995 | 2006-12-19 |
| 1518057249 | Tracy Rebecca Kelly | Radiology | 9200 W Wisconsin Ave, Dept of Radiation Oncology, Milwaukee, WI 53226-3522 | 2006-10-13 |
| 1194820456 | Tracy T Kelly | Internal Medicine | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2006-09-13 |
| Street Address |
3000 SW 148TH AVE SUITE 200 |
| City | MIRAMAR |
| State | FL |
| Zip Code | 33027-4169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700873734 | Anna Falabella | Dermatology | 3000 Sw 148th Ave, Ste 250, Miramar, FL 33027-4169 | 2005-10-04 |
| 1689114480 | Kidz Medical Services, Inc | Pediatrics | 3000 Sw 148th Ave, Suite 112, Miramar, FL 33027-4181 | 2017-02-28 |
| 1114479755 | Florida Orthopedic & Injury Centers | Orthopaedic Surgery | 3000 Sw 148th Ave, Suite 200, Miramar, FL 33027-4169 | 2016-10-31 |
| 1013377191 | South Florida Spine & Sports Specialists, LLC | Physical Medicine & Rehabilitation | 3000 Sw 148th Ave, Suite 115, Miramar, FL 33027-4169 | 2016-03-02 |
| 1114302841 | Medirectors, LLC | General Practice | 3000 Sw 148th Ave, Suite 215, Miramar, FL 33027-4169 | 2015-07-23 |
| 1629236104 | Leavitt Medical Associates of Florida Inc | Dermatology | 3000 Sw 148th Ave, Sutie 250, Miramar, FL 33027-4169 | 2008-05-30 |
| 1033302260 | Francisco Flores Md Pa | Dermatology | 3000 Sw 148th Ave, Suite 250, Miramar, FL 33027-4169 | 2007-08-21 |
| 1821298746 | Charles Keith Raynor | Dentist | 3000 Sw 148th Ave, Miramar, FL 33027-4169 | 2007-07-19 |
| 1023121563 | Ladynez Espinal | Obstetrics & Gynecology | 3000 Sw 148th Ave, Suite 215, Miramar, FL 33027-4169 | 2006-08-17 |
| 1750396206 | Ronald D. Smith & Eduardo Weiss Md Pa | Specialist | 3000 Sw 148th Ave, Suite 250, Miramar, FL 33027-4169 | 2006-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474808 | A&d Community Mental Health, LLC | Community/Behavioral Health | 1333 Sw 16th Ave, Pembroke Pines, FL 33027 | 2020-10-12 |
| 1275172256 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 12681 Miramar Parkway, Miramar, FL 33027 | 2019-12-23 |
| 1902449424 | Marine M Brown | Nurse Practitioner | 4343 Sw 128th Avenue, Mirmar, FL 33027 | 2019-10-28 |
| 1427699107 | Suncare Therapy, Inc | Physical Therapist | 111 Grant Palms Dr, Pembroke Pines, FL 33027 | 2019-10-03 |
| 1245888080 | Nicole Angelique Munoz | Nurse Practitioner | 12600 Pembroke Rd Ste 200, Miramar, FL 33027 | 2019-08-26 |
| 1770052334 | Katalyst Health, LLC | Family Medicine | 14704 Sw 11 Street, Pembroke Pines, FL 33027 | 2018-11-13 |
| 1700362076 | Jovani Miguel Gonzalez | Dentist | 3600 Sw 163rd Ave, Miramar, FL 33027 | 2018-07-19 |
| 1336648310 | Janelle Monique Mitchell | Behavior Technician | 3350 Sw 148th Ave Suite 110, Miramar, FL 33027 | 2018-02-06 |
| 1437667557 | Elizabeth Connors | Specialist/Technologist | 17089 Sw 16th St, Pembroke Pines, FL 33027 | 2018-01-11 |
| 1992217806 | Bibi Farida Roberts | Counselor | 3590 Sw 142nd Ave, Miramar, FL 33027 | 2017-11-01 |
| Find all providers in zip 33027 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972141836 | Ryan Malossi | Physician Assistant | 9250 Ashley Dr, Miramar, FL 33025-3809 | 2019-12-11 |
| 1780220152 | Leighton Parkins | Physician Assistant | 2293 Sw 182nd Way, Miramar, FL 33029-5251 | 2019-11-20 |
| 1508409020 | Maria Razzaq | Physician Assistant | 16534 Sw 39th St, Miramar, FL 33027-4638 | 2019-10-28 |
| 1184266082 | Juliana Escobar Restrepo | Physician Assistant | 9278 Sw 39th St, Miramar, FL 33025-7353 | 2019-10-11 |
| 1871055400 | Valerie Dominguez | Physician Assistant | 19025 Sw 25th Ct, Miramar, FL 33029-2464 | 2019-04-02 |
| 1609395813 | Marcela Bernal | Physician Assistant | 2251 W Preserve Way Apt 204, Miramar, FL 33025-6595 | 2017-09-19 |
| 1144771080 | Samson Saint Fleur | Physician Assistant | 19198 Sw 26th St, Miramar, FL 33029-2498 | 2016-10-15 |
| 1194181321 | Angelica Merlano | Physician Assistant | 12701 Sw 42nd St, Miramar, FL 33027-6024 | 2016-01-04 |
| 1235500844 | Jean-baptiste Pierre | Physician Assistant | 2741 Laguna Way, Miramar, FL 33025-4218 | 2015-10-08 |
| 1942548987 | Johan Isaiah Garel | Physician Assistant | 3908 S State Road 7, Miramar, FL 33023-6162 | 2013-01-25 |
| Find all providers in MIRAMAR | ||||
Please comment or provide details below to improve the information on MRS. TRACY ANN KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.