Individual
ELIZABETH LAURA JUSTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5612 NW 43RD ST, GAINESVILLE, FL 32653-3332
(352) 376-4542
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(352) 376-4542
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9218478
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014319400
—
FL
01
—
OB894
MEDICARE HF
FL
Enumeration date
12/28/2007
Last updated
09/16/2021
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