Healthcare Provider Details

I. General information

NPI: 1700155686
Provider Name (Legal Business Name): ELIZABETH DANA JAFFE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 S ORANGE AVE
ORLANDO FL
32806-1226
US

IV. Provider business mailing address

320 E NORTH AVE STE 401
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 941-444-0011
  • Fax: 603-952-3900
Mailing address:
  • Phone: 412-359-4352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9108580
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number134344
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: