Individual
ELIZABETH M PEPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
206 E NEW HAVEN AVE, MELBOURNE, FL 32901-4504
(321) 802-3311
(321) 802-5324
Mailing address
9 GALEN ST STE 240, WATERTOWN, MA 02472-4522
(857) 268-3190
(617) 562-5289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS 0005398
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593671762
CHAMPUS TRICARE
—
01
—
80187
BLUE SHIELD
—
Enumeration date
10/11/2005
Last updated
09/12/2023
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