KEVIN T KELLY (NPI# 1750323747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750323747 |
| Entity Type | Individual |
| Full Name | KEVIN T KELLY |
| Credential | MD |
| Practice Address |
1397 Medical Park Blvd Suite 240 Wellington FL 33414-3186 |
| Mailing Address |
6333 N Federal Hwy Suite 300 Ft Lauderdale FL 33308-1907 |
| Practice Telephone | 5617843788 |
| Practice Fax Number | 9542293100 |
| Mailing Telephone | 9547766880 |
| Mailing Fax Number | 9542293100 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | ME56260 | FL | Allopathic & Osteopathic Physicians |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
ME56260 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AETNA | 4360358 | 01 |
| FL | BLUE CROSS BLUE SHIELD | 08555 | 01 |
| FL | AVMED | 230941 | 01 |
| FL | 055262300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083255681 | Kevin Michael Kelly | Pharmacist | 704 Fairview Rd, Simpsonville, SC 29680-7117 | 2019-10-04 |
| 1326528787 | Kevin Howard Kelly | Marriage & Family Therapist | 5272 S Shamrock Cir, Kearns, UT 84118-7007 | 2018-08-15 |
| 1952848525 | Kevin Kelly | Social Worker | 1010 Delafield Rd Rm 1a105, Pittsburgh, PA 15215-1802 | 2017-01-20 |
| 1912300435 | Kevin Michael Kelly | Occupational Therapist | 1287 Cedar Shoals Dr Apt 718, Athens, GA 30605-3596 | 2014-09-29 |
| 1376972943 | Kevin Joseph Kelly | Nurse Practitioner | 117 E North 1st St, Roby, TX 79543-2354 | 2013-11-05 |
| 1801006515 | Kevin Michael Kelly | Chiropractor | 20 Summer St, Rockland, ME 04841-2918 | 2007-05-23 |
| 1184762627 | Kevin George Kelly | Nurse Practitioner | 331 North Ave, Wood Ridge, NJ 07075-2035 | 2007-02-04 |
| 1760597421 | Kevin James Kelly | Psychologist | 2800 Cornerstone Drive, Suite 110, Pagosa Springs, CO 81147 | 2006-08-20 |
| 1619984309 | Kevin William Kelly | Psychologist | 2013 State Street, East Petersburg, PA 17520-1216 | 2006-08-02 |
| 1730116625 | Kevin M Kelly | Emergency Medicine | 310 Greenview Way, Bowling Green, KY 42103-8767 | 2006-06-27 |
| Street Address |
1397 MEDICAL PARK BLVD SUITE 240 |
| City | WELLINGTON |
| State | FL |
| Zip Code | 33414-3186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376525899 | Robert J Abiusi | Physician Assistant | 1397 Medical Park Blvd, Suite 260, Wellington, FL 33414-6156 | 2005-11-18 |
| 1720462393 | Sabrina Lewis | Nurse Practitioner | 1397 Medical Park Blvd, Suite 220, Wellington, FL 33414-3186 | 2015-07-14 |
| 1073810289 | Florida Woman Care, LLC | Obstetrics & Gynecology | 1397 Medical Park Blvd, Suite 360, Wellington, FL 33414-3188 | 2011-02-24 |
| 1891937884 | Peter Henry Schwartz | Internal Medicine | 1397 Medical Park Blvd, Ste 420, Wellington, FL 33414-3186 | 2009-04-06 |
| 1275798472 | Wellington Physician Alliances Inc | Surgery | 1397 Medical Park Blvd, Suite 180, Wellington, FL 33414-3186 | 2008-07-28 |
| 1225293681 | Pain and Rehabilitation Physicians of Palm Beach Inc | Pain Medicine | 1397 Medical Park Blvd, Suite 480, Wellington, FL 33414-3186 | 2008-07-25 |
| 1922275239 | Emilio B Torres Professional Association | Obstetrics & Gynecology | 1397 Medical Park Blvd, Suite 200, Wellington, FL 33414-3186 | 2008-05-15 |
| 1881886455 | Patricia Helen Somera | Nurse Practitioner | 1397 Medical Park Blvd, Suite 360, Wellington, FL 33414-3186 | 2007-08-16 |
| 1538363742 | Kevin T Kelly M D Pa | Ophthalmology | 1397 Medical Park Blvd, Suite 240, Wellington, FL 33414 | 2007-06-12 |
| 1154451474 | Complete Healthcare for Women | Obstetrics & Gynecology | 1397 Medical Park Blvd, Suite 360, Wellington, FL 33414-3186 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932707247 | Juana Maria Gonzales | Home Health | 2766 Penhall Ct, Wellington, FL 33414 | 2020-10-09 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1730661158 | Michelle Alexis Anagnostu | Nurse Practitioner | 1447 Medical Park Blvd Suite 406, Wellington, FL 33414 | 2018-09-01 |
| 1932686193 | Borola Inc | Occupational Therapy Assistant | 1985 Canterbury Circle, Wellington, FL 33414 | 2018-07-20 |
| 1841783156 | Kid'z World Advance Inc | Behavioral Analyst | 2400 Wrotham Ter, Wellington, FL 33414 | 2018-06-11 |
| 1134619489 | Devin Michael Scheller | Counselor | 2077 Vinings Circle Apt 1303, Wellington, FL 33414 | 2018-05-12 |
| 1942726617 | Amanda Hardy | Social Worker | 11120 South Way, Suite 1, Wellington, FL 33414 | 2017-08-15 |
| 1467976423 | Dawn Carnegia Blackshear | Nurse Practitioner | 1397 Medical Park Blvd Ste 480, Wellington, FL 33414 | 2017-08-01 |
| 1508390238 | Morgan Mccollum | Speech-Language Pathologist | 2158 Polo Gardens Dr Apt 203, Wellington, FL 33414 | 2017-04-19 |
| 1003369786 | Memite G Charlemagne | Registered Nurse | 184 Berenger Walk, Royal Palm Beach, FL 33414 | 2016-07-28 |
| Find all providers in zip 33414 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253791 | Miami Eye & Retina, Inc | Ophthalmology | 4305 N Jefferson Ave, Miami Beach, FL 33140-2933 | 2018-04-24 |
| 1831608496 | Comprehensive Retina Consultants Pllc | Ophthalmology | 1501 N Us Highway 441 Ste 1106, The Villages, FL 32159-6800 | 2017-09-27 |
| 1538441811 | Pautler Cohen Findlay and Eichenbaum Mds Pa | Ophthalmology | 12903 N 56th St, Temple Terrace, FL 33617-1225 | 2011-09-13 |
| 1497076335 | Elizabeth R Richter | Ophthalmology | 3920 Bee Ridge Rd Bldg D, Sarasota, FL 34233-1207 | 2010-06-15 |
| 1013234624 | Christopher Roy Stelton | Ophthalmology | 3400 S Tamiami Trl Ste 101, Sarasota, FL 34239 | 2010-04-23 |
| 1457389447 | Mandeep Singh Dhalla | Ophthalmology | 6333 N Federal Hwy Ste 300, Fort Lauderdale, FL 33308 | 2006-06-29 |
| 1336144575 | Karina Billiris Findlay | Ophthalmology | 2705 W Saint Isabel St, Tampa, FL 33607-6319 | 2005-06-15 |
| 1659998482 | Don Hershelson Noel | Ophthalmology | 900 Nw 17th St, Miami, FL 33136-1119 | 2020-06-27 |
| 1457918625 | Gary Shienbaum Md Pa | Ophthalmology | 7261 Sheridan St Ste 100b, Hollywood, FL 33024-2708 | 2019-05-23 |
| 1235625039 | South Florida Retina Institute, Pllc | Ophthalmology | 20900 Ne 30th Ave Ste 207, Aventura, FL 33180 | 2018-07-03 |
| Find all providers with the same taxonomy | ||||
| City | WELLINGTON |
| Zip Code | 33414 |
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| 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.