Individual
ELISE FORTIN RIDDLE
Active
Individual
ELISE FORTIN RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME93814
FL
2080P0202X
Pediatric Cardiology Physician
Primary
ME93814
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000064200
—
FL
01
—
ME93814
MEDICAL LICENSE
FL
Enumeration date
10/06/2005
Last updated
11/16/2016
Update your record
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