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NPI Code Detail

MEDICARE: ELIZABETH PETRELL APRN

MEDICARE: ELIZABETH PETRELL APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN11040774FL

General Provider Information

NPI Number : 1477444313
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH PETRELL APRN
Provider Business Mailing Address
First Line : 900 VILLAGE SQUARE XING STE 290
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33410-4552
Country : US
Telephone Number : 239-313-2517
Fax Number : 239-313-2555
Provider Business Practice Location Address
First Line : 2601 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34994-4622
Country : US
Telephone Number : 772-219-2777
Fax Number : 772-219-0017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2025
Last Update Date : 07/10/2025

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Directions to “ ELIZABETH PETRELL APRN” Practice Location

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