Ellaine Dupuis, PT
Individual provider Active NPI Physical Therapist · Jay, FL
NPI 1740949676 · NPPES record last updated Dec 8, 2021
Key facts
- NPI
- 1740949676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 3964 Florida Ave
Jay, FL 32565-1104 - Phone
- (850) 741-6715
- NPI assigned
- Dec 8, 2021
- 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)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
3964 Florida Ave
Jay, FL 32565-1104
Mailing address
3964 Florida Ave
Jay, FL 32565-1104
Other providers in Jay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.