MEDICARE: DR. MARGARET NICOLE INGERSOLL ELY DO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1851186290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET NICOLE INGERSOLL ELY DO

Provider Business Mailing Address
First Line	:	700 6TH ST S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-4815
Country	:	US
Telephone Number	:	727-893-6191
Fax Number	:	727-553-7340

Provider Business Practice Location Address
First Line	:	700 6TH ST S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-4815
Country	:	US
Telephone Number	:	727-893-6191
Fax Number	:	727-553-7340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	04/14/2025

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