Provider Demographics
NPI:1376247742
Name:ELMORE, ISABELLA ELORA (SLPA)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:ELORA
Last Name:ELMORE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DANUBE AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3528
Mailing Address - Country:US
Mailing Address - Phone:321-506-0103
Mailing Address - Fax:
Practice Address - Street 1:121 DANUBE AVE APT 206
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3528
Practice Address - Country:US
Practice Address - Phone:321-506-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist