MEDICARE: ELISA ARAUJO ATC

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
1	2255A2300X	Athletic Trainer	1888	FL

General Provider Information

NPI Number	:	1184679813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISA ARAUJO ATC

Provider Business Mailing Address
First Line	:	7941 GEORGIAN BAY CIR
Second Line	:	#111
City	:	FT MYERS
State	:	FL
Zip	:	33912-5655
Country	:	US
Telephone Number	:	239-340-8386
Fax Number	:

Provider Business Practice Location Address
First Line	:	10501 FGCU BLVD S
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33965-6502
Country	:	US
Telephone Number	:	239-590-7056
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/08/2007

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