Provider Demographics
NPI:1457595233
Name:WEBER, ELIZABETH L (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:WEBER
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:PO BOX 494710
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-4710
Mailing Address - Country:US
Mailing Address - Phone:941-613-2400
Mailing Address - Fax:941-613-2401
Practice Address - Street 1:1111 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-5526
Practice Address - Country:US
Practice Address - Phone:941-833-4400
Practice Address - Fax:941-833-4401
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9265870363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00824OtherBC/BS FLORIDA
FL6417334OtherCIGNA
FL5872736OtherAETNA
FLARNP9265870OtherNP LICENSE
FL1255052OtherUHC