| Mr Shawn Demian Kelly, APRN | |
|
1667 N Clyde Morris Blvd Ste 2, Daytona Beach, FL 32117-5500 | |
| (386) 274-1414 | |
| Not Available |
| Full Name | Mr Shawn Demian Kelly |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 16 Years |
| Location | 1667 N Clyde Morris Blvd Ste 2, Daytona Beach, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174831093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APRN9431397 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventhealth Daytona Beach | Daytona beach, FL | Hospital |
| Florida Hospital Flagler | Palm coast, FL | Hospital |
| Adventhealth New Smyrna Beach | New smyrna beach, FL | Hospital |
| Halifax Health Medical Center | Daytona beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lakeside Endocrine Associates Inc | 9133408008 | 5 |
| Entity Name | Lakeside Endocrine Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871041681 PECOS PAC ID: 9133408008 Enrollment ID: O20161116002444 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Shawn Demian Kelly, APRN 1667 N Clyde Morris Blvd Ste 2, Daytona Beach, FL 32117-5500 Ph: (386) 274-1414 | Mr Shawn Demian Kelly, APRN 1667 N Clyde Morris Blvd Ste 2, Daytona Beach, FL 32117-5500 Ph: (386) 274-1414 |
Ashley Gillette, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 112 Milton Rd, Daytona Beach, FL 32118 Phone: 970-260-0885 | |
Debra Dowell, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 731 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-257-1626 Fax: 866-486-1253 | |
Daisy Mae Pila De La Pena, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 417 Champion Ridge Dr, Daytona Beach, FL 32124 Phone: 321-203-8382 | |
Bruce Harris, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3512 S Atlantic Ave, Daytona Beach, FL 32118 Phone: 386-767-9544 | |
Cloressa Dizney, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-425-4542 Fax: 386-425-7705 | |
Lyne E Homeus, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1845 Holsonback Dr., Daytona Beach, FL 32117 Phone: 386-274-0500 | |
Souad Omri, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 305 Memorial Medical Pkwy, Daytona Beach, FL 32117 Phone: 386-615-0900 |