Individual
ELIZABETH F CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., LLC
Contact information
Practice address
7978 COOPER CREEK BLVD, SUITE 204, UNIVERSITY PARK, FL 34201-2141
(941) 308-7546
(941) 308-7550
Mailing address
7978 COOPER CREEK BLVD, SUITE 204, UNIVERSITY PARK, FL 34201-2141
(941) 308-7546
(941) 308-7550
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME89181
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A58
BCBS GROUP ID
FL
01
—
10D1031789
CLIA
FL
01
—
1376576454
GROUP NPI
FL
01
—
145A6
JANELLE BC#
FL
01
—
48310
BC PROVIDER#
FL
01
—
ME89181
ST LICENSE#
FL
Enumeration date
09/12/2005
Last updated
09/29/2009
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