Provider Demographics
NPI:1750385431
Name:SILKES, ELLEN D (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:D
Last Name:SILKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3920 BEE RIDGE ROAD
Mailing Address - Street 2:BLDG. C, STE. B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:941-923-6800
Mailing Address - Fax:941-922-2263
Practice Address - Street 1:3920 BEE RIDGE ROAD
Practice Address - Street 2:BLDG. C, STE. B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-923-6800
Practice Address - Fax:941-922-2263
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL46279207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0404535-00Medicaid
FLD58990Medicare UPIN
FL79946Medicare ID - Type Unspecified