Provider Demographics
NPI:1477701100
Name:NESBIHAL, ELAINE (OTR)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:
Last Name:NESBIHAL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 PINEHURST RD APT 23H
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-3660
Mailing Address - Country:US
Mailing Address - Phone:727-656-3744
Mailing Address - Fax:
Practice Address - Street 1:1701 PINEHURST RD APT 23H
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-3660
Practice Address - Country:US
Practice Address - Phone:727-656-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4908171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor