Provider Demographics
NPI:1447364492
Name:ELLISON, JILMA H (OD)
Entity type:Individual
Prefix:DR
First Name:JILMA
Middle Name:H
Last Name:ELLISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3635 ALOMA AVE
Mailing Address - Street 2:STE 1029
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6395
Mailing Address - Country:US
Mailing Address - Phone:407-678-9151
Mailing Address - Fax:
Practice Address - Street 1:3607 ALOMA AVE STE 1081
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8811
Practice Address - Country:US
Practice Address - Phone:407-678-9151
Practice Address - Fax:321-682-7299
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4126152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management