| Kelly Gendall, MD | |
|
410 Atlantic Blvd, Neptune Beach, FL 32266-4022 | |
| (610) 217-2625 | |
| Not Available |
| Full Name | Kelly Gendall |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 22 Years |
| Location | 410 Atlantic Blvd, Neptune Beach, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942418579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME132441 (Florida) | Secondary |
| 208D00000X | General Practice | ME132441 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Solantic Of Jacksonville Llc | 1052409307 | 42 |
| Entity Name | Solantic/south Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851344378 PECOS PAC ID: 5496762171 Enrollment ID: O20060321000740 |
| Entity Name | Solantic Of Jacksonville Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407893100 PECOS PAC ID: 1052409307 Enrollment ID: O20071120000271 |
| Entity Name | Hma-solantic Joint Venture Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689812109 PECOS PAC ID: 6002955788 Enrollment ID: O20091209000716 |
| Entity Name | Shands-solantic Joint Venture Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558595223 PECOS PAC ID: 4183764178 Enrollment ID: O20091223000343 |
| Entity Name | West Boynton Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003172628 PECOS PAC ID: 0941456537 Enrollment ID: O20120815000049 |
| Entity Name | Carespot Of Orlando Hsi Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306367503 PECOS PAC ID: 8921372558 Enrollment ID: O20170921000186 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Gendall, MD 255 12th St, Atlantic Beach, FL 32233-5707 Ph: () - | Kelly Gendall, MD 410 Atlantic Blvd, Neptune Beach, FL 32266-4022 Ph: (610) 217-2625 |