Healthcare Provider Details

I. General information

NPI: 1700821782
Provider Name (Legal Business Name): ELIZABETH B RONAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S.W. ARCHER ROAD
GAINESVILLE FL
32608-1197
US

IV. Provider business mailing address

11106 W COVE HARBOR DR
CRYSTAL RIVER FL
34428-6226
US

V. Phone/Fax

Practice location:
  • Phone: 800-324-8387
  • Fax: 352-379-4055
Mailing address:
  • Phone: 352-794-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9215782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: