Individual
MRS. ELEANOR THEOBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1010 S FEDERAL HWY STE 1010, DELRAY BEACH, FL 33483-5132
(561) 413-9511
Mailing address
408 NE 6TH ST UNIT 334, FT LAUDERDALE, FL 33304-6407
(443) 837-8805
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
PA9116006
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/24/2020
Last updated
10/24/2022
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