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Kelvin Royce Bray

Hospitalist

Allopathic & Osteopathic Physicians

820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205

PECOS Enrollment

This provider is enrolled in PECOS as KELVIN BRAY.

Based on the most recent information from CMS, provider Kelvin Royce Bray is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1205807443
Provider Type
Individual
Full Name
Bray, Kelvin Royce
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
1/27/2006
Last Updated
6/28/2024

Contact Information

Practice Location

820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205

(904) 202-3860

(904) 202-3846

Mailing Location

PO Box 746638, Atlanta, GA 30374-6638

(904) 202-1032

(904) 376-4107

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License ME96493 Florida
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME96493 Florida

Provider Identifiers

ID	Description	Issuer
ID 2768593-00	Description Medicaid	Issuer Unlisted Florida
ID P00469557	Description Other	Issuer RR MEDICARE Florida
ID 801102130A	Description Medicaid	Issuer Unlisted Georgia

Kelvin Royce Bray

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

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ID

Description

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Description

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ID

Description

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Musto, Michele L.

Pai, Savita

Griffin, Robert Laurence

Stone-Smith, Abbie Marie

Poling, Ryan David

Doan, Tad C

Naimi, Haroon

Romanelli, Mathew Charles

Karmand, Arezo June

Hunjan, Gurdip Singh