Provider Demographics
NPI:1508313412
Name:WALTERS, EMILY CIRELLI (PA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CIRELLI
Last Name:WALTERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5106
Mailing Address - Country:US
Mailing Address - Phone:941-208-1556
Mailing Address - Fax:
Practice Address - Street 1:2901 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5106
Practice Address - Country:US
Practice Address - Phone:941-208-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant