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NPI Code Detail

MEDICARE: ELIZABETH NAGALES

MEDICARE: ELIZABETH NAGALES
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
1243U00000XRadiology Practitioner Assistant
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1417646415
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH NAGALES
Provider Business Mailing Address
First Line : 6675 CORPORATE CENTER PKWY STE 115
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-8088
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6675 CORPORATE CENTER PKWY STE 115
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-8088
Country : US
Telephone Number : 904-245-8910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2023
Last Update Date : 01/21/2026

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Directions to “ ELIZABETH NAGALES ” Practice Location

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