Provider Demographics
NPI:1164938072
Name:KUBEK, ELZBIETA
Entity Type:Individual
Prefix:
First Name:ELZBIETA
Middle Name:
Last Name:KUBEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, STE. 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-7436
Mailing Address - Country:US
Mailing Address - Phone:703-914-8000
Mailing Address - Fax:
Practice Address - Street 1:451 S MILWEE ST STE 1010
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4137
Practice Address - Country:US
Practice Address - Phone:321-424-6950
Practice Address - Fax:407-599-7246
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9350389363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner