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General NPI Number Information
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NPI Number | 1073906202
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Entity Type | Organization
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Legal Business Name | DAVID O. ELLIOTT M.D.PA
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 1218 W DIXIE AVE SUITE B
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City | LEESBURG
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State | FL
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Zip | 34748-6380
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Country | US
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Telephone | 352-326-5132
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Fax | 352-326-3315
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Provider Business Mailing Address
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Address Line | 1218 W DIXIE AVE STE B
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City | LEESBURG
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State | FL
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Zip | 34748-6380
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Country | US
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Telephone | 352-326-5132
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Fax | 352-326-3315
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DR. EVA YOLANDA ELLIOTT
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Credential | PHD
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Telephone | 352-326-5132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME38031
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License Number State | FL
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