Healthcare Provider Details

I. General information

NPI: 1790219236
Provider Name (Legal Business Name): ELIZABETH ELBADRI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH PLASENCIA M.D.

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 HOWELL BRANCH RD
WINTER PARK FL
32792-1069
US

IV. Provider business mailing address

5245 OAK ISLAND RD
BELLE ISLE FL
32809-3553
US

V. Phone/Fax

Practice location:
  • Phone: 407-478-6249
  • Fax:
Mailing address:
  • Phone: 786-260-8645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME150009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: