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

Ralph Ellis IV

Individual provider Physical Therapy Assistant · NPI 1699628750

Ralph Ellis IV is a Physical Therapy Assistant in Fort Walton Beach, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2026

Practice location Address checks out

1020 Titan Ct Ste 102
Fort Walton Beach, FL 32547-6638
Phone: (850) 863-7581
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA34467 (FL)

Record details

NPI number1699628750
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 18, 2026
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026

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