Provider Demographics
NPI:1306375456
Name:BRENNER, KELSEY (DC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:BRENNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SW 22ND ST STE 306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2945
Mailing Address - Country:US
Mailing Address - Phone:786-800-2888
Mailing Address - Fax:786-800-3834
Practice Address - Street 1:1330 SW 22ND ST STE 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2945
Practice Address - Country:US
Practice Address - Phone:786-800-2888
Practice Address - Fax:786-800-3834
Is Sole Proprietor?:No
Enumeration Date:2017-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11741111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology