Healthcare Provider Details

I. General information

NPI: 1205032372
Provider Name (Legal Business Name): ELIZABETH SPILLERS PALUBIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH SPILLERS

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14302 RAVENWOOD LN
TAMPA FL
33618-2030
US

IV. Provider business mailing address

14302 RAVENWOOD LN
TAMPA FL
33618-2030
US

V. Phone/Fax

Practice location:
  • Phone: 727-612-4648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT23417
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: