Provider Demographics
NPI:1801474234
Name:CONNOLLY, ELIZABETH CATHERINE
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CATHERINE
Last Name:CONNOLLY
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 1:2326 S CONGRESS AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7652
Mailing Address - Country:US
Mailing Address - Phone:561-433-5577
Mailing Address - Fax:561-275-2696
Practice Address - Street 1:2326 S CONGRESS AVE STE 1A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7652
Practice Address - Country:US
Practice Address - Phone:561-433-5577
Practice Address - Fax:561-275-2696
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4591213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty