Provider Demographics
NPI:1841057478
Name:ETLINGER, ETHAN ANDREW (PA-C)
Entity type:Individual
Prefix:MR
First Name:ETHAN
Middle Name:ANDREW
Last Name:ETLINGER
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:100 MACARTHUR CSWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5101
Mailing Address - Country:US
Mailing Address - Phone:361-218-6484
Mailing Address - Fax:
Practice Address - Street 1:100 MACARTHUR CSWY
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5101
Practice Address - Country:US
Practice Address - Phone:361-218-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant