MEDICARE: DR. ELIZABETH MUDDIMAN CEFALU M.D., M.P.H.

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
1	207R00000X	Internal Medicine Physician	ME108366	FL
2	208000000X	Pediatrics Physician	ME108366	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00913647	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	14AC7	OTHER	FL	BCBS FLORIDA

General Provider Information

NPI Number	:	1811956683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH MUDDIMAN CEFALU M.D., M.P.H.

Provider Business Mailing Address
First Line	:	2572 COMMERCE PKWY
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34289-9332
Country	:	US
Telephone Number	:	941-888-5839
Fax Number	:	941-888-5840

Provider Business Practice Location Address
First Line	:	2572 COMMERCE PKWY
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34289-9332
Country	:	US
Telephone Number	:	941-888-5839
Fax Number	:	941-888-5840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	04/27/2025

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