Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Renee Black

Individual provider Athletic Trainer · NPI 1508384736

Kelly Renee Black is a Physician Assistant in Clearwater, Florida. Qualified in 2022, 4 years ago. Practices with Synergic Healthcare Solutions LLC, a 96-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
4
Licensed in
PA
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

430 Morton Plant St Ste 301
Clearwater, FL 33756-3395
Phone: (813) 978-9700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3301 W Gandy Blvd, Tampa, FL 33611-2931 — (813) 925-1903

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Athletic Trainer Taxonomy 2255A2300X (PA)

Record details

NPI number1508384736
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 8, 2017
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Synergic Healthcare Solutions Llc — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Other providers in Clearwater