Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellenton Family Practice Direct PLLC

Organization Family Medicine Physician · NPI 1124471503

Ellenton Family Practice Direct PLLC provides Family Medicine Physician services in Ellenton, Florida. Licensed in Florida. Registered with an NPI since 2016.

Licensed in
FL
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

907 25th Dr E
Ellenton, FL 34222-2053
Phone: (941) 321-8299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence PA9102767 (FL)

Record details

NPI number1124471503
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Hervig — Office Manage And Partner · (941) 730-5326
NPI enumeratedJuly 20, 2016
Last updated in NPPESMarch 7, 2023
Mailing address907 25th Dr E, Ellenton, FL 34222-2053

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