BETHANY LAQUELL ELLIS (NPI# 1194349308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194349308 |
| Entity Type | Individual |
| Full Name | BETHANY LAQUELL ELLIS |
| Other Name | BETHANY LAQUELL ELLIS |
| Credential | FNP |
| Practice Address |
210 S Federal Hwy Ste 300 Hollywood FL 33020-6811 |
| Mailing Address |
1221 S 23rd Ave Hollywood FL 33020-5912 |
| Practice Telephone | 9546845493 |
| Mailing Telephone | 9546845493 |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11007347 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033425806 | Bethany Ann Ellis | Specialist | 5545 Highway 145, Shannon, MS 38868-9351 | 2010-08-31 |
| 1649765108 | Bethany Ellis | Licensed Practical Nurse | 14 Franklin St, Westfield, NY 14787-1009 | 2018-06-27 |
| 1396925848 | Bethany Anne Ellis | Developmental Therapist | 100 Erdman Way, Leominster, MA 01453-1804 | 2007-11-13 |
| Street Address |
210 S FEDERAL HWY STE 300 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33020-6811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694203 | Oaks Medical Group, LLC | Internal Medicine | 2854 Jackson St, Hollywood, FL 33020 | 2020-06-19 |
| 1487217949 | Yaneisy Correa Vento Sr. | Nurse Practitioner | 2700 E Hollywood Blud, Hollywood, FL 33020 | 2019-04-19 |
| 1811453590 | Sandra's Car Service LLC | Non-emergency Medical Transport (VAN) | 2048 Mckinley St. Bay #1, Hollywood, FL 33020 | 2019-02-18 |
| 1134605330 | Cruz Ines Diaz | Peer Specialist | 3400 N- 29th Avenue, Hollywood, FL 33020 | 2018-07-11 |
| 1598258451 | Brian Tran | Dentist | 1704 Stirling Rd., Hollywood, FL 33020 | 2018-06-14 |
| 1295223451 | Broward Treatment Center | Substance Abuse Rehabilitation Facility | 1101 S 21 Ave, Hollywood, FL 33020 | 2018-04-24 |
| 1033617220 | Laura Goldman | Psychologist | 2514 Hollywood Blvd Ste 404, Hollywood, FL 33020 | 2018-01-23 |
| 1205344835 | Sunshine Health Supplies LLC | Durable Medical Equipment & Medical Supplies | 1926 Hollywood Blvd Ste 204, Hollywood, FL 33020 | 2018-01-17 |
| 1124536222 | Melina Rodriguez | Counselor | 3400 N 29th Avenue, Hollywood, FL 33020 | 2018-01-11 |
| 1003337783 | Publix Super Markers, Inc | Durable Medical Equipment & Medical Supplies | 1776 Polk St., Hollywood, FL 33020 | 2017-07-03 |
| Find all providers in zip 33020 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739897 | Vanessa Arias | Nurse Practitioner | 931 S Park Rd Apt 207, Hollywood, FL 33021-8762 | 2020-10-31 |
| 1659979656 | Hendy Aubourg | Nurse Practitioner | 6940 Tyler St, Hollywood, FL 33024-7456 | 2020-10-12 |
| 1811509920 | Cynthia Remy | Nurse Practitioner | 11178 Mainsail Dr, Hollywood, FL 33026-4726 | 2020-08-19 |
| 1487264040 | Jorge Rolando Remon | Nurse Practitioner | 6230 Garfield St, Hollywood, FL 33024-5943 | 2020-08-07 |
| 1922618115 | Alba M Beltran | Nurse Practitioner | 7361 Cleveland St, Hollywood, FL 33024-5463 | 2020-08-03 |
| 1588280630 | Jackelyn Mi Bhattarai | Nurse Practitioner | 11018 Nashville Dr, Hollywood, FL 33026-4966 | 2020-06-24 |
| 1255951026 | Nicole Blum | Nurse Practitioner | 4712 Arthur St, Hollywood, FL 33021-4737 | 2020-04-22 |
| 1497383103 | Vanessa D King-smith | Nurse Practitioner | 6660 Meade St, Hollywood, FL 33024-1914 | 2020-03-29 |
| 1538793039 | Lyudmyla Tymtsyas | Nurse Practitioner | 4200 Hillcrest Dr Apt 304, Hollywood, FL 33021-7900 | 2020-02-24 |
| 1528690609 | Marlen Rubiera | Nurse Practitioner | 1030 N 71st Ave, Hollywood, FL 33024-5540 | 2020-02-06 |
| Find all providers in HOLLYWOOD | ||||
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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.