Individual
DR. ELLEN ROARK BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6535 NEMOURS PKWY, ORLANDO, FL 32827-7884
(407) 567-4000
(407) 567-5924
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4100
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4852
OK
207L00000X
Anesthesiology Physician
OS014028
PA
207L00000X
Anesthesiology Physician
OTO11386
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
OS18251
FL
Other
Enumeration date
11/21/2009
Last updated
04/30/2024
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