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Individual

DR. ELLEN MARCOLONGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
5985 49TH ST N, ST PETERSBURG, FL 33709-2111
(727) 527-5060
(727) 230-9194
Mailing address
148 115TH AVE NE, ST PETERSBURG, FL 33716-2801
(727) 577-3759

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9205990
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01130239
AMERIGROUP-MEDICARE
FL
01
1062439
CAREPLUS
FL
01
15607001
CITRUS-49TH STREET
FL
01
15607002
CITRUS-PASADENA AVE S
FL
01
15607003
CITRUS-WEST BAY
FL
01
201266825
BEECH STREET
FL
01
3082130
MEDIPASS
FL
01
308213000
MEDIPASS
FL
05
308213000
FL
01
308266
AVMED
FL
01
P00662873
MEDICARE-RAILROAD
FL
01
P03332
FREEDOM HEALTH
FL
01
Y113D
BLUE CROSS BLUE SHEILD OF FLORIDA
FL
Enumeration date
02/16/2007
Last updated
06/22/2015
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