LYNNE M. ELLIS MDPA NPI 1912056540

NPI Information

NPI: 1912056540
Provider Name: LYNNE M. ELLIS, MD,PA
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Address: 1111 7TH AVE N STE 103
ST PETERSBURG, FL
ZIP 33705
Phone: (727) 822-5393

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NPI Details

LYNNE M. ELLIS, MD,PA is a primary care clinic center in St Petersburg, FL. LYNNE M. ELLIS, MD,PA NPI is 1912056540. The provider is registered as an organization entity type.

The provider's business location address is:

1111 7TH AVE N STE 103
ST PETERSBURG, FL
ZIP 33705-348
Phone: (727) 822-5393

The provider's authorized official is Lynne M Ellis .
The authorized official title is President and has the following contact phone number (727) 822-5393.

The enumeration date for this NPI number is 1/10/2007 and was last updated on 9/25/2012.

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	261QP2300X	Clinic/Center	Primary Care	46897	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	262210600	MEDICAID	FLORIDA

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: 11/21/2025

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