Individual
ELLA HADLEY MODEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
Mailing address
10700 CITY CENTER BLVD APT 5409, PEMBROKE PINES, FL 33025-4446
(985) 249-9413
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME173244
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
06/13/2022
Last updated
08/04/2025
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