Individual provider · Type 1 NPI

Ellen R. Fortier, PA

Medical Physician Assistant · St. Petersburg, FL

NPI number 1699754002 Active

Practice location

2191 9th Ave N, Suite 240
St. Petersburg, FL 33713-7146

Call (727) 821-7163 Map

Fax (727) 822-6017

Mailing address

3212 W Fielder St
Tampa, FL 33611-2912

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA 0003227 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1699754002

Ellen R. Fortier, PA's National Provider Identifier is 1699754002, issued on Jan 13, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Petersburg, FL. The record was last updated on Jul 13, 2026.