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General NPI Number Information
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NPI Number | 1811664501
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Entity Type | Individual
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Provider Name | SHELBY ELIZABETH VIJAPURA
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 1000 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5266
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Country | US
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Telephone | 352-253-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 30 W PRESTON ST
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City | ORLANDO
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State | FL
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Zip | 32804-3849
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Country | US
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Telephone | 727-267-7007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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