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NPI Code Detail

MEDICARE: ELIYSHEBA JUDITH ANGELICA MCCRAE-BROWN

MEDICARE: ELIYSHEBA JUDITH ANGELICA MCCRAE-BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianM237-059-41-000-0FL

General Provider Information

NPI Number : 1053249631
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIYSHEBA JUDITH ANGELICA MCCRAE-BROWN
Provider Business Mailing Address
First Line : 3801 SW 13TH ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-3542
Country : US
Telephone Number : 772-418-6654
Fax Number :
Provider Business Practice Location Address
First Line : 8001 BEATY GROVE DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-1602
Country : US
Telephone Number : 813-926-5454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ ELIYSHEBA JUDITH ANGELICA MCCRAE-BROWN ” Practice Location

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