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NPI Code Detail

MEDICARE: ELLIANA WALSTER

MEDICARE: ELLIANA WALSTER
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician AssistantPA9119488FL

General Provider Information

NPI Number : 1811602881
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIANA WALSTER
Provider Business Mailing Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 954-262-1250
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 954-262-1250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2023
Last Update Date : 11/21/2024

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Directions to “ ELLIANA WALSTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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