Individual
ELIZABETH VALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5380 TECH DATA DR STE 101, CLEARWATER, FL 33760-3122
(727) 210-8191
Mailing address
339 BROADWAY, DUNEDIN, FL 34698-7514
(646) 379-5415
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
9367567
FL
163WP0200X
Pediatric Registered Nurse
9367567
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11007138
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106816800
—
FL
Enumeration date
03/03/2020
Last updated
02/03/2025
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