Provider Demographics
NPI:1730476649
Name:ASHE, KELLI MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:MARIE
Last Name:ASHE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9697 ARBOR OAKS LN APT 202
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1781
Mailing Address - Country:US
Mailing Address - Phone:706-589-9403
Mailing Address - Fax:
Practice Address - Street 1:21679 STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1812
Practice Address - Country:US
Practice Address - Phone:561-482-3338
Practice Address - Fax:561-482-8025
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3907213EP0504X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X, 213E00000X
FLPO3097213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery