Individual
DR. JOHN ELLIS CONLEY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2152 GOLD DUST CT, TRINITY, FL 34655-5015
(727) 375-8619
Mailing address
2152 GOLD DUST CT, TRINITY, FL 34655-5015
(727) 375-8619
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101241572
VA
2084P0800X
Psychiatry Physician
23641
AZ
2084P0800X
Psychiatry Physician
Primary
55683
FL
2084P0800X
Psychiatry Physician
MD6535
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11388A
FL MEDICARE B PROVIDER NUMBER
FL
05
—
270964300
—
FL
Enumeration date
03/20/2007
Last updated
11/02/2009
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