Provider Demographics
NPI:1184679813
Name:ARAUJO, ELISA (ATC)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:ARAUJO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7941 GEORGIAN BAY CIR
Mailing Address - Street 2:#111
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-5655
Mailing Address - Country:US
Mailing Address - Phone:239-340-8386
Mailing Address - Fax:
Practice Address - Street 1:10501 FGCU BLVD S
Practice Address - Street 2:
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33965-6502
Practice Address - Country:US
Practice Address - Phone:239-590-7056
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer