Individual
MATTHEW S ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 W NEWBERRY RD STE 104, GAINESVILLE, FL 32605-4399
(352) 333-5918
(352) 333-4684
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
ME96520
FL
207Q00000X
Family Medicine Physician
ME96520
FL
Other
Enumeration date
05/27/2006
Last updated
08/05/2020
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