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NPI Code Detail

MEDICARE: DR. KEVIN ELLORIN DMD

MEDICARE: DR. KEVIN ELLORIN DMD
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
1122300000XDentistDN28324FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184302671
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN ELLORIN DMD
Provider Business Mailing Address
First Line : 27809 MANOR OAK DR APT 103
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-5379
Country : US
Telephone Number : 757-348-8983
Fax Number :
Provider Business Practice Location Address
First Line : 5348 BRUCE B DOWNS BLVD
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-8612
Country : US
Telephone Number : 813-973-1837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2023
Last Update Date : 07/06/2023

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Directions to “ DR. KEVIN ELLORIN DMD” Practice Location

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