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Tashiana Kelly
Point of Service in Jacksonville, Florida
NPI 1528666146

Tashiana Kelly is a Point of Service based in Jacksonville, FL. Tashiana Kelly practices in Jacksonville, FL. The NPI Number for Tashiana Kelly is 1528666146 and holds a License No. W689477 (Florida).

The current practice location address for Tashiana Kelly is 2611 University Blvd N Apt C203, Jacksonville, FL and can be reached out via phone at 904-248-2208.

Location: 2611 University Blvd N Apt C203, Jacksonville, FL, 32211-3287
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1528666146
Provider Name
Tashiana Kelly
Credential
Provider Entity Type
Individual
Gender
Female
Address
2611 University Blvd N Apt C203, Jacksonville, FL, 32211-3287
Phone Number
904-248-2208
Fax Number
Provider Enumeration Date
10/15/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
K400801859330 01 FL STATE IDENTIFICATION
institution
Provider Business Practice Location Address Details
Address
2611 University Blvd N Apt C203
City
Jacksonville
State
Florida
Zip
32211-3287
Phone Number
904-248-2208
Fax Number
person
Provider Business Mailing Address Details
Address
2611 University Blvd N Apt C203
City
Jacksonville
State
Florida
Zip
32211-3287
Phone Number
904-248-2208
Fax Number
person
Provider's Taxonomy Details 1
Type
Managed Care Organizations
Classification
Point of Service
Speciality
-
Taxonomy
305S00000X
License No.
W689477 (Florida)
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
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