Ellenton Family Practice Direct Pllc

NPI #1124471503 in Ellenton, Florida

Provider Information

NPI Number: 1124471503
Entity Type: Organization
Organization Name: Ellenton Family Practice Direct Pllc
Primary Specialty: Family Medicine
Enumeration Date: Jul 20, 2016
Last Updated: Mar 7, 2023

Practice Location

Address: 907 25TH DR E
City: Ellenton
State: Florida
ZIP Code: 34222-2053
Phone: (941) 321-8299

Authorized Official

Name: MR. DAVID ALLAN HERVIG, PA-C
Title: OFFICE MANAGE AND PARTNER
Phone: (941) 730-5326

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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