Healthcare Provider Details

I. General information

NPI: 1750783916
Provider Name (Legal Business Name): ELIZABETH PEZDEK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 N SEMORAN BLVD SUITE 102
WINTER PARK FL
32792-3800
US

IV. Provider business mailing address

483 N SEMORAN BLVD SUITE 102
WINTER PARK FL
32792-3800
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-1847
  • Fax: 321-274-0246
Mailing address:
  • Phone: 407-645-1847
  • Fax: 321-274-0246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9374607
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: