Individual
KOBE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
KOBE ELLIS
Contact information
Practice address
9283 SAN JOSE BLVD, JACKSONVILLE, FL 32257-5584
(904) 568-5242
Mailing address
9283 SAN JOSE BLVD, JACKSONVILLE, FL 32257-5584
(904) 568-5242
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/10/2011
Last updated
02/23/2021
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