Kellie A Faro, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA18884 Issued in FL

Practice address

100 S Scenic Hwy Ste 105
Lake Wales, FL 33853-3827

Phone

(863) 676-2225

Fax

(863) 676-0698

NPI assigned

Jan 14, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Professional Chiropractic

  • Chiropractor
  • Lake Wales, FL
  • NPI 1891004065
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1033356985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S SCENIC HWY STE 105",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533827",
            "telephone_number": "863-676-2225",
            "fax_number": "863-676-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S SCENIC HWY STE 105",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533827",
            "telephone_number": "863-676-2225",
            "fax_number": "863-676-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARO",
        "first_name": "KELLIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA18884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Specialists of Mid Florida, PA
• Alma Fajardo, OTR
• Family Vision Services, P.a.
• Halim Farag, RPH
• Anthony Edward Faro III, B.S.,M.S.,D.C.,FIAMA
• Felicia a. Watts, LLC
• Benigno Feliciano, MD
• Natasha L Fenelon, APRN
• Rodolfo S Fernandez, MD
• Kaylee Fichthorn, PT, DPT

• Specialist in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.