Provider Demographics
NPI:1063840569
Name:ELMORE, BEVERLY DORSON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:DORSON
Last Name:ELMORE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5130 SUNFOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6327
Mailing Address - Country:US
Mailing Address - Phone:727-824-0780
Mailing Address - Fax:727-568-6011
Practice Address - Street 1:14451 UNIVERSITY COVE PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3741
Practice Address - Country:US
Practice Address - Phone:813-977-4001
Practice Address - Fax:813-971-3688
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2021-12-14
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Provider Licenses
StateLicense IDTaxonomies
FLPA9107359363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant