Individual
LYNNE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 7TH AVE N, #103, ST PETERSBURG, FL 33705-1348
(727) 822-5393
Mailing address
1111 7TH AVE N, #103, ST PETERSBURG, FL 33705-1348
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME46897
FL
Other
Enumeration date
01/24/2006
Last updated
07/08/2007
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