| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CYNTHIA KELLY | 1578151072 | 2021-01-10 |
| Entity Type | Individual |
| Provider Name | Cynthia Kelly RN |
| Practice Office Address | 12614 TIBOLI CHASE CT APT 2 BOCA RATON, FL US |
| Practice Office Telephone | 5613503732 |
| Mailing Address | 12614 TIBOLI CHASE CT APT 2 BOCA RATON, FL 334964304 US |
| Business Telephone | 5613503732 |
| Code | License No | State |
|---|---|---|
| 163W00000X PRIMARY | 2932432 | FL |