MEDICARE: ELIZABETH ANNE ALBUQUERQUE MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	ME171267	FL

General Provider Information

NPI Number	:	1720661085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANNE ALBUQUERQUE MD

Provider Business Mailing Address
First Line	:	1757 OCOEE APOPKA RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-9263
Country	:	US
Telephone Number	:	407-249-1234
Fax Number	:	407-249-1755

Provider Business Practice Location Address
First Line	:	1757 OCOEE APOPKA RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-9263
Country	:	US
Telephone Number	:	407-249-1234
Fax Number	:	407-249-1755

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

Provider Enumeration Date	:	05/04/2021
Last Update Date	:	02/13/2026

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