Individual
AMBER ELLERIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13417 US HIGHWAY 301 STE D, DADE CITY, FL 33525-5446
(352) 567-8640
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(352) 567-0188
(813) 355-5101
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9114743
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/12/2019
Last updated
10/14/2021
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