Individual
DR. BETH HARPER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-5911
Mailing address
5054 NW 22ND ST, GAINESVILLE, FL 32605-5474
(352) 514-2610
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME106676
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003743200
—
FL
Enumeration date
05/21/2008
Last updated
08/03/2011
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