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Organization

CHRISTIAN ELLIS MD PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTIAN ELLIS MD (MEDICAL DIRECTOR)
(239) 404-6641
Entity
Organization

Contact information

Practice address
11181 HEALTH PARK BLVD STE 1170, NAPLES, FL 34110-5734
(239) 596-8814
Mailing address
300 DUNES BLVD APT 704, NAPLES, FL 34110-6438
(239) 404-6641

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME101183
FL

Other

Enumeration date
05/22/2012
Last updated
05/22/2012
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