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Organization
ELLIS INTEGRATIVE FAMILY PRACTICE INC
Active
Organization
ELLIS INTEGRATIVE FAMILY PRACTICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETTA ELLIS ARNP (PRESIDENT)
(352) 457-1936
Entity
Organization
Contact information
Practice address
1865 NIGHTINGALE LN STE B, TAVARES, FL 32778-4360
(352) 457-1936
Mailing address
1865 NIGHTINGALE LN, TAVARES, FL 32778-4360
(352) 457-1936
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/29/2021
Last updated
04/19/2021
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