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General NPI Number Information
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NPI Number | 1871403766
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Entity Type | Individual
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Provider Name | MARIA VON ELLM-MCKENNA PA-S
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Gender | Female
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 105 COMMERCIAL CENTER DR
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City | RUSKIN
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State | FL
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Zip | 33573-6827
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Country | US
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Telephone | 814-871-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 MIZNER BAY AVE
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City | BRADENTON
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State | FL
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Zip | 34208-2574
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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