Provider Demographics
NPI:1619286275
Name:ELLEN SILKES M D P A
Entity Type:Organization
Organization Name:ELLEN SILKES M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SILKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-923-6800
Mailing Address - Street 1:3920 BEE RIDGE RD
Mailing Address - Street 2:BLDG. C, STE. B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-923-6800
Mailing Address - Fax:941-922-2263
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BLDG. C, STE. B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-923-6800
Practice Address - Fax:941-922-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46279207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58990Medicare UPIN