Staten, Keely M

Staten, Keely M is an individual health care provider with primary practice located at 525 N Dacie Pt , Lecanto FL 34461-8399. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Staten, Keely M can be contacted via phone (813) 321-1786.

Contact Information

Primary practice address
525 N Dacie Pt Lecanto FL 34461-8399
Phone: (813) 321-1786
Fax: (813) 321-1787
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9112684 Florida

Profile Details

NPI number 1649758004
LBN Legal business name Staten, Keely M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2018
Last updated Nov 12th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649758004 NPPES
Florida MEDICAID 106795900
Florida Other PA00357

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