Provider Demographics
NPI:1053666370
Name:REED, KELLY L (DO)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:L
Last Name:REED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:85 BAY BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4468
Mailing Address - Country:US
Mailing Address - Phone:850-735-3376
Mailing Address - Fax:559-201-1269
Practice Address - Street 1:85 BAY BRIDGE DR
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4468
Practice Address - Country:US
Practice Address - Phone:850-735-3376
Practice Address - Fax:559-201-1269
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A15550207N00000X
FLOS17445207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology