Provider Demographics
NPI:1699027821
Name:ARMIJO, ELENA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9279
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-9279
Mailing Address - Country:US
Mailing Address - Phone:239-440-6456
Mailing Address - Fax:239-236-0337
Practice Address - Street 1:13691 METRO PKWY STE 400
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4349
Practice Address - Country:US
Practice Address - Phone:394-406-4562
Practice Address - Fax:239-236-0337
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106710363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical