Ellis Pediatrics, Pllc

NPI #1134844426 in Jacksonville, Florida

Provider Information

NPI Number: 1134844426
Entity Type: Organization
Organization Name: Ellis Pediatrics, Pllc
Primary Specialty: Pediatrics
Enumeration Date: Oct 10, 2022
Last Updated: Mar 1, 2023

Practice Location

Address: 12086 FORT CAROLINE RD STE 401
City: Jacksonville
State: Florida
ZIP Code: 32225-7640
Phone: (904) 456-9240

Authorized Official

Name: KENYANITA ELLIS, DO
Title: OWNER/PEDIATRICIAN
Phone: (904) 456-9240

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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