MEDICARE: ESTHER ELDER PA

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	363A00000X	Physician Assistant	PA9104212	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891980579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER ELDER PA

Provider Business Mailing Address
First Line	:	2501 N ORANGE AVE
Second Line	:	SUITE 411
City	:	ORLANDO
State	:	FL
Zip	:	32804-4644
Country	:	US
Telephone Number	:	407-303-1373
Fax Number	:	407-303-2478

Provider Business Practice Location Address
First Line	:	2501 N ORANGE AVE
Second Line	:	SUITE 411
City	:	ORLANDO
State	:	FL
Zip	:	32804-4644
Country	:	US
Telephone Number	:	407-303-1373
Fax Number	:	407-303-2478

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

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	11/12/2014

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Directions to “ ESTHER ELDER PA” Practice Location

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