Organization
ELEVATE MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA C HARRELL (BILLING MANAGER)
(662) 501-0043
Entity
Organization
Contact information
Practice address
2349 VANDERBILT BEACH RD STE 508, NAPLES, FL 34109-2776
(662) 501-0043
(662) 562-0161
Mailing address
106 EAGLE ST, SENATOBIA, MS 38668-9501
(662) 501-0043
(662) 562-0161
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104322
FL
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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