Individual
ELIZABETH MARIE AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 312-3456
(321) 676-9196
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 312-3456
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9217891
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP9217891
FLORIDA LICENSE
FL
01
—
EW744X
MEDICARE
FL
Enumeration date
04/06/2011
Last updated
03/05/2025
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