Kelly, Tashiana
Kelly, Tashiana is an sole proprietor health care provider with primary practice located at 2611 University Blvd N Apt C203 , Jacksonville FL 32211-3287. She recently has only one registered license in Managed Care Organizations / Point of Service, which is considered as her primary health care specialty. Kelly, Tashiana can be contacted via phone (904) 248-2208.Contact Information
Primary practice address
2611 University Blvd N Apt C203
Jacksonville FL 32211-3287
Phone: (904) 248-2208
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Managed Care Organizations / Point of Service | 305S00000X | W689477 | Florida |
Profile Details
| NPI number | 1528666146 |
|---|---|
| LBN Legal business name | Kelly, Tashiana |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 15th, 2020 |
| Last updated | Oct 15th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528666146 | NPPES |
| Florida | Other | K400801859330 | STATE IDENTIFICATION |
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