Individual
ELIZABETH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11534 LUCKYGEM DR, RIVERVIEW, FL 33579-2116
(813) 484-2817
Mailing address
11534 LUCKYGEM DRI, RIVERVIEW, FL 33579-2116
(813) 484-2817
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
25651
FL
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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