Provider Demographics
NPI:1174368732
Name:MACDONELL, ELIZABETH I (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:I
Last Name:MACDONELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:943 S BENEVA RD STE 306
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2499
Mailing Address - Country:US
Mailing Address - Phone:941-955-1108
Mailing Address - Fax:941-954-4440
Practice Address - Street 1:3333 CATTLEMEN RD STE 208
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6058
Practice Address - Country:US
Practice Address - Phone:941-379-5121
Practice Address - Fax:941-379-4239
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2025-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9118895363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant