Ennis, Elizabeth Margaret

Ennis, Elizabeth Margaret is an individual health care provider with primary practice located at 550 Pope Ave Nw Ste 200 , Winter Haven FL 33881-4679. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ennis, Elizabeth Margaret can be contacted via phone (863) 299-2630.

Contact Information

Primary practice address
550 Pope Ave Nw Ste 200 Winter Haven FL 33881-4679
Phone: (863) 299-2630
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA 9105563 Florida

Profile Details

NPI number 1063733376
LBN Legal business name Ennis, Elizabeth Margaret
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2010
Last updated Nov 18th, 2022 - about 4 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 1063733376 NPPES
Florida Other PA-9105563 DEPARTMENT OF HEALTH
Florida MEDICAID 002747500 DEPARTMENT OF HEALTH
Florida Other 1780221774 DEPARTMENT OF HEALTH
Florida Other 342264 DEPARTMENT OF HEALTH
Florida Other PAX 0008401 DEPARTMENT OF HEALTH
Florida Other YO5FR DEPARTMENT OF HEALTH

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