Provider Demographics
NPI:1598272726
Name:AUSTIN, ELIZABETH VUKELICH (PA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:VUKELICH
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1818 SW 1ST AVE APT 1501
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1188
Mailing Address - Country:US
Mailing Address - Phone:698-698-2301
Mailing Address - Fax:
Practice Address - Street 1:1625 SE 3RD AVE # 723
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-616-1916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9110984363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical