Provider Demographics
NPI:1447636436
Name:KELLY, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FAIRWAY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1811
Mailing Address - Country:US
Mailing Address - Phone:954-354-3738
Mailing Address - Fax:954-354-0171
Practice Address - Street 1:600 FAIRWAY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1811
Practice Address - Country:US
Practice Address - Phone:954-354-3738
Practice Address - Fax:954-354-0171
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS3295237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist