Provider Demographics
NPI:1538299979
Name:BURCAW, ELIZABETH ANN (ARNP,BC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BURCAW
Suffix:
Gender:F
Credentials:ARNP,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13906 LAKESHORE BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-1487
Mailing Address - Country:US
Mailing Address - Phone:727-863-7000
Mailing Address - Fax:727-863-7007
Practice Address - Street 1:13906 LAKESHORE BLVD STE 340
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1487
Practice Address - Country:US
Practice Address - Phone:727-863-7000
Practice Address - Fax:727-863-7007
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1769702363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7209ZMedicare ID - Type Unspecified
FLP22333Medicare UPIN