ELLIS FRANKLIN FORT

NEW SMYRNA BEACH, FL
NPI1497060396
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA9105205)
Enumeration Date2010-08-16
Last Update Date2019-05-30
Business Address
Mr. ELLIS FRANKLIN FORT PA-C
502 PALMETTO ST
NEW SMYRNA BEACH, FL 32168
Phone number: 386-957-1854
Mailing Address
Mr. ELLIS FRANKLIN FORT PA-C
502 PALMETTO ST
NEW SMYRNA BEACH, FL 32168-7325
Phone number: 869-571-8543
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