Healthcare Provider Details

I. General information

NPI: 1356261341
Provider Name (Legal Business Name): MALEEKA MONIQUE ELLIS RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 SANDLAKE COMMONS BLVD
ORLANDO FL
32819-8033
US

IV. Provider business mailing address

2010 E PRESIDENT ST APT 1203
SAVANNAH GA
31404-1046
US

V. Phone/Fax

Practice location:
  • Phone: 407-674-5001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: