Provider Demographics
NPI:1982767745
Name:ZAFAR, ELAINE-MARIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE-MARIA
Middle Name:
Last Name:ZAFAR
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 1:14005 LAVANTE CT
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-8003
Mailing Address - Country:US
Mailing Address - Phone:239-297-8338
Mailing Address - Fax:239-992-4693
Practice Address - Street 1:8381 RIVERWALK PARK BLVD STE 202
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-8760
Practice Address - Country:US
Practice Address - Phone:239-274-0005
Practice Address - Fax:239-274-8185
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101011363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013973320OtherGROUP NPI
FLU4394ZMedicare ID - Type UnspecifiedIDENTIFICATION NUMBER
FLQ39397Medicare UPIN