Ellis, Kenneth
Ellis, Kenneth is an sole proprietor health care provider with primary practice located at 1099 Augusta Falls Way , Naples FL 34119-1362. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Ellis, Kenneth can be contacted via phone (239) 595-1774.Contact Information
Primary practice address
1099 Augusta Falls Way
Naples FL 34119-1362
Phone: (239) 595-1774
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | OS 6596 | Florida |
Profile Details
| NPI number | 1447248133 |
|---|---|
| LBN Legal business name | Ellis, Kenneth |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 7th, 2005 |
| Last updated | Mar 7th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447248133 | NPPES |
| Florida | MEDICAID | 275519000 | |
| Florida | Other | 57885 |
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