Provider Demographics
NPI:1801380415
Name:CIOCIA, KELSEY ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANNE
Last Name:CIOCIA
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 BEXLEY VILLAGE DR # 200
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-2721
Mailing Address - Country:US
Mailing Address - Phone:813-467-4771
Mailing Address - Fax:813-467-4783
Practice Address - Street 1:2435 BEXLEY VILLAGE DR # 200
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-2721
Practice Address - Country:US
Practice Address - Phone:813-467-4771
Practice Address - Fax:813-467-4783
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
FLPA9118694363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant