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General NPI Number Information
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NPI Number | 1861952715
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Entity Type | Individual
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Provider Name | ELENORA VIDAL-PASCAL
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2351 PHILLIPS RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5333
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Country | US
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Telephone | 850-877-8166
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Fax | 850-877-0431
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Provider Business Mailing Address
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Address Line | PO BOX 102222
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City | ATLANTA
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State | GA
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Zip | 30368-2222
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Country | US
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Telephone | 239-274-8200
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11001913
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | 11001913
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11001913
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License Number State | FL
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