Basic Information
| Provider Information | |||||||||
| NPI: | 1558620179 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEBB | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | HAGELUND | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 E FLETCHER AVE | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336134613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136157294 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5380 TECH DATA DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337603122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136157803 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2012 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME143371 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | 4301100359 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.