Provider Demographics
NPI:1376928176
Name:ELIBRI, JUDITH (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:ELIBRI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 GOODLETTE-FRANK RD N
Mailing Address - Street 2:#101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4595
Mailing Address - Country:US
Mailing Address - Phone:239-624-8460
Mailing Address - Fax:239-643-1489
Practice Address - Street 1:2450 GOODLETTE-FRANK RD N
Practice Address - Street 2:#101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4595
Practice Address - Country:US
Practice Address - Phone:239-624-8460
Practice Address - Fax:239-643-1489
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9303192363L00000X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0SL8OtherBCBS
FLIH080ZMedicare PIN