Individual
ELANOR PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5992 BERRYHILL RD STE 205, MILTON, FL 32570-1014
(850) 626-5324
Mailing address
5992 BERRYHILL RD STE 205, MILTON, FL 32570-1014
(850) 293-7247
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112375
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2019
Last updated
03/28/2023
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