Provider Demographics
NPI:1396372538
Name:ARONOFF, KELLY O'MARA (DNP-CRNA)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:O'MARA
Last Name:ARONOFF
Suffix:
Gender:F
Credentials:DNP-CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4836 19TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-3306
Mailing Address - Country:US
Mailing Address - Phone:443-629-8722
Mailing Address - Fax:
Practice Address - Street 1:3835 39TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-4411
Practice Address - Country:US
Practice Address - Phone:443-622-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208210367500000X
FLAPRN11012047367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered