Lynne M. Ellis, Md,pa | |
1111 7th Ave N Ste 103 St Petersburg FL 33705-1348 | |
(727) 822-5393 | |
Not Available |
Full Name | Lynne M. Ellis, Md,pa |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 1111 7th Ave N Ste 103, St Petersburg, Florida |
Authorized Official Name and Position | Lynne M Ellis (PRESIDENT) |
Authorized Official Contact | 7278225393 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lynne M. Ellis, Md,pa 1111 7th Ave N Ste 103 St Petersburg FL 33705-1348 Ph: () - | Lynne M. Ellis, Md,pa 1111 7th Ave N Ste 103 St Petersburg FL 33705-1348 Ph: (727) 822-5393 |
NPI Number | 1912056540 |
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Provider Enumeration Date | 01/10/2007 |
Last Update Date | 09/25/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912056540 | NPI | - | NPPES |
262210600 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 46897 (Florida) | Primary |
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