ELLIS KEITH GARRETT PA-C NPI 1639162142

NPI Information

NPI: 1639162142
Provider Name: ELLIS KEITH GARRETT, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
12880 COMMODITY PL
CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL
ZIP 33626
Phone: (877) 872-5788
Get Directions

Ellis Keith Garrett, PA-C is a surgical physician assistant in Tampa, FL. Ellis Keith Garrett, PA-C NPI is 1639162142. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12880 COMMODITY PL
CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL
ZIP 33626-101
Phone: (877) 872-5788
Fax: (866) 698-7272

The enumeration date for this NPI number is 8/30/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA0001998	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00040948	OTHER	FLORIDA	RAILROAD MEDICARE PROVIDE
2	S80954	MEDICARE UPIN	FLORIDA
3	E2565A	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA	PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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