Individual
BETHANY LAQUELL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1001 N FEDERAL HWY STE 341, HALLANDALE BEACH, FL 33009-2404
(754) 444-9173
(786) 221-3179
Mailing address
1001 N FEDERAL HWY STE 341, HALLANDALE BEACH, FL 33009-2404
(754) 444-9173
(786) 221-3179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11007347
FL
Other
Enumeration date
06/03/2020
Last updated
09/22/2021
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