Adeline Marcellus Aime

Individual provider Active NPI Nurse Practitioner · Ellenton, FL

NPI 1548092661 · NPPES record last updated Aug 16, 2024

Key facts

NPI
1548092661
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
APRN11034691 (FL)
Practice address
5970 Willows Bridge Loop
Ellenton, FL 34222-5217
Phone
(239) 878-8642
NPI assigned
Aug 16, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
APRN11034691FLMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11034691 FL Yes

Addresses

Primary practice location

5970 Willows Bridge Loop
Ellenton, FL 34222-5217

Mailing address

1631 Heathermoor Way
Dacula, GA 30019-7252
Phone (239) 878-8642

Other practice location 1

1631 Heathermoor Way
Dacula, GA 30019-7252
Phone (239) 878-8642

Other providers in Ellenton, FL

All providers in Ellenton, FL · Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.