Provider Demographics
NPI:1396726030
Name:READ, ELIZABETH J (ARNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:READ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 ROYAL ASCOT RUN
Mailing Address - Street 2:PO BOX 672
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-5116
Mailing Address - Country:US
Mailing Address - Phone:407-443-9092
Mailing Address - Fax:407-295-1041
Practice Address - Street 1:4051 THOMASSA CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-5866
Practice Address - Country:US
Practice Address - Phone:407-579-9371
Practice Address - Fax:407-295-1041
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1474932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S69025Medicare UPIN
E1781BMedicare ID - Type Unspecified