NPI 1780703561

Matthew S Ellis MD PA

Organisation Undersea and Hyperbaric Medicine (Preventive Medicine) Physician Gainesville, FL

Practice location

Address: 6400 W Newberry Rd Suite 104, Gainesville, FL 32605
Phone: (352) 333-5911
Fax: (353) 333-4684
Mailing address: PO Box 3123, St Augustine, FL 32085-3123

Authorised official

Name: Matthew Stewart Ellis
Title: President
Phone: (352) 333-5911

Registered specialties

Undersea and Hyperbaric Medicine (Preventive Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0011X Licence ME96520 (FL)

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Registry record

NPI: 1780703561
Entity type: Organization
NPI issued: 29 Mar 2007
Record last updated: 5 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.