Ellis, Gillian A

Ellis, Gillian A is an individual health care provider with primary practice located at 1900 Don Wickham Dr Mp Sl Admin, Clermont FL 34711-1979. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ellis, Gillian A can be contacted via phone (352) 536-8840.

Contact Information

Primary practice address
1900 Don Wickham Dr Mp Sl Admin Clermont FL 34711-1979
Phone: (352) 536-8840
Fax: (352) 536-8841
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 062791 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME107435 Florida

Profile Details

NPI number 1811196215
LBN Legal business name Ellis, Gillian A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2007
Last updated Nov 11th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811196215 NPPES
Florida MEDICAID 003163400
Florida Other ME107435

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