Healthcare Provider Details

I. General information

NPI: 1407558893
Provider Name (Legal Business Name): CALLOWAY ELIZABETH STIRRAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 NW 6TH ST
GAINESVILLE FL
32601-4020
US

IV. Provider business mailing address

1408 NW 6TH ST FL 32601
GAINESVILLE FL
32601-4020
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-4411
  • Fax: 352-373-4455
Mailing address:
  • Phone: 352-373-4411
  • Fax: 352-373-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: