# MARK I ELLEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1720181951
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | ME145025 | FL | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2005-01826 | NC | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | 25MA06361300 | NJ | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | 50578 | GA | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | G71376 | CA | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | MD051555L | PA | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | ME145025 | FL | — |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 05/18/2020