Mrs. Tracy A. Kelly PA
Physician Assistant in Miramar, FL(View on Map)
Full Name
Mrs. Tracy Ann Kelly PA
NPI Number
1194949388
NPI Type
Individual Provider
Gender
Female
Enumeration Date
04/12/2007
Specialties
(Taxonomies)Code
363A00000X
363AM0700X
246Z00000X
Primary Taxonomy
Yes
No
No
Licenses
State
Florida
Virginia
Virginia
License Number
PA9105943
012000974
0110003365
Contact
Information
Purpose
Mailing
Location
Address
3000 SW 148TH AVE
3000 SW 148TH AVE
City
Miramar
Miramar
State
FL
FL
Postal Code
33027-4169
33027-4169
Country
US
US
Telephone Number
(703) 244-9469
(703) 244-9469
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 04/30/2019
Provider Address
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