Individual
SAVANNAH CLARE ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
(813) 974-0483
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9119406
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124470100
—
FL
01
—
4KBEC
BCBS
FL
Enumeration date
01/29/2024
Last updated
03/20/2025
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