Provider Demographics
NPI:1013229574
Name:BELL, KELLI RUDISILL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLI
Middle Name:RUDISILL
Last Name:BELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KELLI
Other - Middle Name:LYNN
Other - Last Name:RUDISILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5749 SW 75TH DR
Mailing Address - Street 2:APT 229
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist