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DEIRDRE WOOLSEY ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
8600 ASTRONAUT BLVD, PORT CANAVERAL, FL 32920-4306
(703) 261-1100
Mailing address
1366 44TH ST, SARASOTA, FL 34234-4628
(703) 929-4983

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002387
VA
363A00000X
Physician Assistant
Primary
PA9112912
FL

Other

Enumeration date
11/07/2006
Last updated
05/19/2026
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