Healthcare Provider Details

I. General information

NPI: 1417600263
Provider Name (Legal Business Name): ELIZABETH ANN JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date: 12/28/2024
Reactivation Date: 02/04/2025

III. Provider practice location address

5941 SE FEDERAL HWY
STUART FL
34997-7871
US

IV. Provider business mailing address

184 SW POMEROY ST
STUART FL
34997-4500
US

V. Phone/Fax

Practice location:
  • Phone: 772-210-4335
  • Fax:
Mailing address:
  • Phone: 973-610-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: