| Doctor Name: | DAVID J ELLINGSON |
| NPI Number: | 1144228685 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA9102690 |
| Business Practice Address: | 3120 Waterman Way Tavares, FL - 327785252 |
| Business Phone Number: | 3523431216 |
| Business Fax Number: | 3523431582 |
| Mailing Address: | 3120 Waterman Way, TAVARES |
| State: | FL |
| Postal Code: | 327785252 |
| Phone Number: | 3523431216 |
| Fax Number: | 3523431582 |
| NPI Enumeration Date: | 07/08/2005 |
| NPI Last Update Date: | 04/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA9102690 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |