Ellsworth, Pamela I

Ellsworth, Pamela I is an individual health care provider with primary practice located at 13535 Nemours Pkwy , Orlando FL 32827-7402. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Pediatric Urology. Allopathic & Osteopathic Physicians / Pediatric Urology is her primary health care specialty. Ellsworth, Pamela I can be contacted via phone (407) 567-4000.

Contact Information

Primary practice address
13535 Nemours Pkwy Orlando FL 32827-7402
Phone: (407) 567-4000
Fax: (407) 567-5924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 150422 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X ME129642 Florida
Allopathic & Osteopathic Physicians / Urology 208800000X MD11894 Rhode Island
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X 150422 Massachusetts

Profile Details

NPI number 1417948647
LBN Legal business name Ellsworth, Pamela I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2005
Last updated Jan 13th, 2018 - about 6 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 1417948647 NPPES
Florida MEDICAID 018993600
Florida Other 31017
Florida MEDICAID 3158667
Florida MEDICAID PE45993

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