Provider Demographics
NPI:1619067055
Name:MEADOR, ELIZABETH J (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:MEADOR
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:2600 LAKE LUCIEN DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7233
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-875-0518
Practice Address - Street 1:6290 LINTON BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6409
Practice Address - Country:US
Practice Address - Phone:561-495-1337
Practice Address - Fax:561-495-5892
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2010-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL3153292363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3153292OtherARNP
FL587329Medicare UPIN
FL3153292OtherARNP