MEDICARE: ELLIE'S WORLD PPEC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM3000X	Medically Fragile Infants and Children Day Care

General Provider Information

NPI Number	:	1235017500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLIE'S WORLD PPEC, LLC

Provider Business Mailing Address
First Line	:	210 NE 24TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-4214
Country	:	US
Telephone Number	:	786-352-2850
Fax Number	:

Provider Business Practice Location Address
First Line	:	4265 LAURA ST
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33980-2836
Country	:	US
Telephone Number	:	786-352-2850
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	LISBET FUNDORA PEREIRA
Credential	:
Telephone Number	:	786-352-2850

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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