Individual
ELIJAH SHALAAR DORNEVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 CENTERVILLE ROAD, SUITE 300, TALLAHASSEE, FL 32308
(850) 877-5115
Mailing address
1401 CENTERVILLE ROAD SUITE 300, TALLAHASSEE, FL 32308
(850) 877-5115
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2024
Last updated
03/05/2025
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