Individual provider · Type 1 NPI

Elizabeth Victoria Kelly, PA STUDENT

Student in an Organized Health Care Education/Training Program · Daytona Beach, FL

NPI number 1205764172 Active

Practice location

222 S Peninsula Dr
Daytona Beach, FL 32118-4422

Call (386) 310-3529 Map

Mailing address

1311 Magnolia Bay Ct
Maitland, FL 32751-6472

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1205764172

Elizabeth Victoria Kelly, PA STUDENT's National Provider Identifier is 1205764172, issued on May 11, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Daytona Beach, FL. The record was last updated on May 11, 2026.