Individual
ELLEN MARIE MARIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2943 WILLOWLEAF LN, WESLEY CHAPEL, FL 33544-7372
(269) 967-2799
Mailing address
2943 WILLOWLEAF LN, WESLEY CHAPEL, FL 33544-7372
(269) 967-2799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10411
GA
Other
Enumeration date
12/24/2018
Last updated
11/02/2021
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