Individual
DR. GEORGE FREDERICK ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
89 W COPELAND DR, ORLANDO, FL 32806-2002
(321) 842-6910
(321) 843-5998
Mailing address
571 SAINT JOSEPHS BLVD, FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
163161
NY
208800000X
Urology Physician
ME49437
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273075800
—
FL
01
—
ME49437
MEDICAL LICENSE
FL
Enumeration date
07/12/2006
Last updated
10/25/2018
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