Provider Demographics
NPI:1821361031
Name:ALFORD, KELLY (DVM)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:ALFORD
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28400 OLD 41 RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6812
Mailing Address - Country:US
Mailing Address - Phone:239-992-8387
Mailing Address - Fax:239-949-0232
Practice Address - Street 1:28400 OLD 41 RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-6812
Practice Address - Country:US
Practice Address - Phone:239-992-8387
Practice Address - Fax:239-949-0232
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM11210174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian