Individual
ELIZEBETH J SHALALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11 MAIN ST STE 2, TITUSVILLE, FL 32796-3590
(321) 225-9788
Mailing address
969 COUNTRY CLUB DR, TITUSVILLE, FL 32780-4985
(321) 225-9788
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA103702
FL
246RP1900X
Phlebotomy Technician
3019910435
NY
246Z00000X
Other Specialist/Technologist
3019910440
NY
246Z00000X
Other Specialist/Technologist
3019910444
NY
Other
Enumeration date
08/20/2009
Last updated
11/01/2023
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