Individual
ELIZABETH KEELER MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1132 S 14TH ST, FERNANDINA BEACH, FL 32034-2920
(904) 277-4690
(904) 277-8487
Mailing address
2675 WINKLER AVE STE 200, FORT MYERS, FL 33901-9328
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106747
FL
363AM0700X
Medical Physician Assistant
PA9106747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103385300
—
FL
01
—
LK444
MEDICARE
FL
01
—
Y0QS5
BCBS
FL
Enumeration date
09/12/2012
Last updated
03/02/2026
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