Individual
DR. ELLYN FRANCES THEOPHILOPOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4150 WOODLANDS PKWY STE B, PALM HARBOR, FL 34685-3495
(727) 772-1452
Mailing address
150 N SPRING BLVD, TARPON SPRINGS, FL 34689-3247
(727) 946-9062
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0068251
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377708100
—
FL
Enumeration date
01/13/2010
Last updated
01/13/2010
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