Female

Kelly M. Iannazzo PA-C

Physician Assistant in Celebration, FL(View on Map)

Full Name

Kelly Marie Iannazzo PA-C

NPI Number

1679710149

NPI Type

Individual Provider

Gender

Female

Enumeration Date

01/20/2009

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Florida
Pennsylvania
South Carolina

License Number

PA 9108977
MA053583
1886

Contact
Information

Purpose

Mailing
Location

Address

400 CELEBRATION PL
400 CELEBRATION PL

City

Celebration
Celebration

State

FL
FL

Postal Code

34747-4970
34747-4970

Country

US
US

Telephone Number

(407) 566-4411
(407) 566-4411

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/05/2016

Provider Address

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