Organization
MATTHEW S ELLIS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW STEWART ELLIS MD (PRESIDENT)
(352) 333-5911
Entity
Organization
Contact information
Practice address
6400 W NEWBERRY RD, SUITE 104, GAINESVILLE, FL 32605
(352) 333-5911
(353) 333-4684
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
ME96520
FL
Other
Enumeration date
03/29/2007
Last updated
08/05/2020
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