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Individual

ELLIS LORENZO WEBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10150 HAGEN RANCH RD, BOYNTON BEACH, FL 33437-3776
(561) 736-8141
(561) 736-5662
Mailing address
15280 NW 79TH CT STE 200, MIAMI LAKES, FL 33016-5873
(305) 558-3724
(954) 536-6837

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME70645
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
255840801
FL
Enumeration date
05/30/2006
Last updated
09/05/2025
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