Provider Demographics
NPI:1437104890
Name:PIZARRO, ELENA (AUD)
Entity type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:PIZARRO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 CEASARS CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6507
Mailing Address - Country:US
Mailing Address - Phone:352-735-9202
Mailing Address - Fax:
Practice Address - Street 1:3210 WATERMAN WAY
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5243
Practice Address - Country:US
Practice Address - Phone:352-343-4488
Practice Address - Fax:352-343-7722
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY253231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP36900Medicare UPIN
FLS1052YMedicare ID - Type UnspecifiedMEDICARE PROVIDER #