KELLY ELLIS (NPI# 1104226109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104226109 |
| Entity Type | Individual |
| Full Name | KELLY ELLIS |
| Credential | PTA |
| Practice Address |
9621 Fontainebleau Blvd 515 Miami FL 33172-6814 |
| Practice Telephone | 6785256256 |
| Mailing Telephone | 6785256256 |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | FL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821615279 | Kelly Ellis | Nurse Practitioner | 585 S Union St, Sparta, MI 49345-1505 | 2020-07-01 |
| 1194346759 | Kelly Nicole Ellis | Registered Nurse | 13819 County Road 1131, Flint, TX 75762-2419 | 2020-05-05 |
| 1205455789 | Kelly Wynell Ellis | Physical Medicine & Rehabilitation | 5502 San Juan Dr, Toledo, OH 43612-3336 | 2020-04-14 |
| 1306348834 | Kelly Ellis | Chore Provider | 5033 Saint Annes Dr, Las Vegas, NV 89149-5717 | 2018-02-28 |
| 1992014971 | Kelly Michelle Ellis | Technician, Pathology | 4230 Tree Moss Pl, Humble, TX 77346-4560 | 2010-09-24 |
| 1417189929 | Kelly Pinney Ellis | Counselor | 404 Broadway St, Suite B, South Haven, MI 49090-1421 | 2009-08-17 |
| 1922233246 | Kelly Abbott Ellis | Physical Therapist | 4953 Macaw Ct Ne, Marietta, GA 30066-1286 | 2009-05-17 |
| 1407941057 | Kelly Leigh Ellis | Family Medicine | 301 N 27th St Ste 2, Norfolk, NE 68701-4457 | 2006-10-03 |
| 1073548186 | Kelly Ann Ellis | Social Worker | 39760 Black Mesa Ln, Palm Desert, CA 92260 | 2006-07-11 |
| 1760778559 | Kelly Ellis | Occupational Therapy Assistant | 4109 Highway 98 W, Summit, MS 39666-9132 | 2011-06-21 |
| Street Address |
9621 FONTAINEBLEAU BLVD 515 |
| City | MIAMI |
| State | FL |
| Zip Code | 33172-6814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912546607 | Yong Quality Care Inc | Home Health | 9621 Fontainebleau Blvd, Miami, FL 33172-6814 | 2019-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801366463 | Magela De Las Mercedes Rodriguez | Behavior Technician | 11252 Nw 6 Street, Miami, FL 33172 | 2018-11-27 |
| 1477030666 | Natacha Garcia | Behavior Technician | 181 Nw 97 Ave Apto 416, Miami, FL 33172 | 2018-07-20 |
| 1720578701 | Marisela Hernandez | Behavioral Analyst | 10825 Nw 7th St Apt 12, Miami, FL 33172 | 2018-05-15 |
| 1083113054 | Fuerza Vital Medical Institute, Corp | Speech-Language Pathologist | 8725 Nw 18 Terr Suite 209, Doral, FL 33172 | 2018-02-06 |
| 1063923522 | Kristen Nicole Otero | Counselor | 1414 Nw 107 Ave Suite 109, Doral, FL 33172 | 2017-10-23 |
| 1003327339 | All Orthopedic Supplies Corp | Prosthetic/Orthotic Supplier | 175 Fontainbleau Blvd, Ste P1, Miami, FL 33172 | 2017-10-13 |
| 1861901944 | Lyanne M Melendez | Speech-Language Pathologist | 1750 Nw 107 Ave, Unit P-901, Miami, FL 33172 | 2017-09-21 |
| 1295259166 | Family Tender Care Services Inc | Behavioral Analyst | 9360 Fontainebleau Blvd, Unit 514, Miami, FL 33172 | 2017-08-01 |
| 1992229074 | Maria F Palabez | Behavior Technician | 9369 Fontainebleau Blvd J225, Miami, FL 33172 | 2017-07-31 |
| 1700306602 | Jenny Lemus | Behavior Technician | 10200 Nw 25th St Suite 205, Doral, FL 33172 | 2017-06-21 |
| Find all providers in zip 33172 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011013 | Aldo Menendez Arcia | Student in an Organized Health Care Education/Training Program | 12250 Nw 8th St, Miami, FL 33182-2421 | 2020-10-21 |
| 1285233403 | Angel Rose Picart | Student in an Organized Health Care Education/Training Program | 12741 Sw 108th St, Miami, FL 33186-3514 | 2020-10-19 |
| 1801494166 | Jason Duran | Student in an Organized Health Care Education/Training Program | 1457 Nw 50th St, Miami, FL 33142-4161 | 2020-10-09 |
| 1881292159 | Rosalyn Viaros | Student in an Organized Health Care Education/Training Program | 5220 Sw 115th Ave., Miami, FL 33165 | 2020-10-09 |
| 1457958662 | Cristian Perez | Student in an Organized Health Care Education/Training Program | 3060 Nw 96th St, Miami, FL 33147-2353 | 2020-10-01 |
| 1659988509 | Karen Hernandez | Student in an Organized Health Care Education/Training Program | 3871 Sw 147th Ave Apt 5, Miami, FL 33185-4006 | 2020-09-24 |
| 1255948329 | Joel Emilio Diaz-portorreal | Student in an Organized Health Care Education/Training Program | 14727 Sw 112th Ter, Miami, FL 33196-3326 | 2020-09-23 |
| 1205442043 | Elizabeth Granado | Student in an Organized Health Care Education/Training Program | 14293 Sw 145th Pl, Miami, FL 33186-6787 | 2020-09-17 |
| 1598370678 | Christian Marcos | Student in an Organized Health Care Education/Training Program | 2930 Sw 93rd Ct, Miami, FL 33165-3147 | 2020-09-15 |
| 1255944658 | Tali Epelbaum | Student in an Organized Health Care Education/Training Program | 3105 Ne 210th Ter, Miami, FL 33180-3911 | 2020-08-25 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.