Provider Demographics
NPI:1609479443
Name:PASIOURITS, ELIZABETH C
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:PASIOURITS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 CAPTIVA CIR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4070
Mailing Address - Country:US
Mailing Address - Phone:727-271-3511
Mailing Address - Fax:
Practice Address - Street 1:7120 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6938
Practice Address - Country:US
Practice Address - Phone:727-848-3442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist