ELIZABETH VIDAL (NPI# 1205330198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205330198 |
| Entity Type | Individual |
| Full Name | ELIZABETH VIDAL |
| Credential | PA-C |
| Practice Address |
4020 Winter Garden Vineland Rd Ste 101 Winter Garden FL 34787 |
| Mailing Address |
4020 Winter Garden Vineland Rd Winter Garden FL 34787-9502 |
| Practice Telephone | 4079936120 |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 9110762 | FL | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | 9110762 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14050 Town Loop Blvd, Orlando, FL 328376190 | 4078526650 | |
| 1503 Buenos Aires Blvd, The Villages, FL 321596821 | 3527532812 | |
| 1951 Sw 172nd Ave Ste 404, Miramar, FL 330295614 | 9544473200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134332240 | Elizabeth Vidal | Psychiatry & Neurology | 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 | 2007-05-07 |
| Street Address |
4020 WINTER GARDEN VINELAND RD STE 101 |
| City | WINTER GARDEN |
| State | FL |
| Zip Code | 34787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608736 | Mid-florida Endodontics - Winter Garden Pa | Dentist | 15815 Shaddock Drive, Unit-3, Winter Garden, FL 34787 | 2020-10-30 |
| 1770196131 | Hamlin Eye Care, LLC | Optometrist | 15820 Shaddock Drive, Suite 150, Winter Garden, FL 34787 | 2020-08-26 |
| 1710501879 | Hz Surgery Center LLC | Clinic/Center | 17085 Porter Road, Suite 110, Winter Garden, FL 34787 | 2020-06-04 |
| 1235759416 | Callie Rebecca Alt | Student in an Organized Health Care Education/Training Program | 2200 Fowler Grove Blvd, Suite 220, Winter Garden, FL 34787 | 2020-04-17 |
| 1992345102 | Advn Dental Partners Pa | Dentist | 516 S. Dillard Street, Winter Garden, FL 34787 | 2020-01-15 |
| 1942851225 | Sara Walker | Physical Therapist | 213 S Dillard Street, Suite 320c, Winter Garden, FL 34787 | 2019-09-26 |
| 1801449996 | Tiffani Green | Behavior Technician | 678 W Bay St Apt 52, Winter Garden, FL 34787 | 2019-07-18 |
| 1811461353 | Ricardo Villalobos Pa | Psychiatry & Neurology | 16606 Broadwater Ave, Winter Garden, FL 34787 | 2019-01-17 |
| 1871078089 | Alton Graydon Cumberbatch Sr. | Pharmacist | 646 S. Dillard Street, Winter Garden, FL 34787 | 2018-10-03 |
| 1629551395 | Andrew Petersen | Physical Therapy Assistant | 5204 W. Colonial Drive, Winter Garden, FL 34787 | 2018-09-10 |
| Find all providers in zip 34787 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528608171 | Tyeshia Massey | Physician Assistant | 1064 Mildred Dixon Way, Winter Garden, FL 34787-2939 | 2020-01-12 |
| 1497752679 | Shannon Delong | Physician Assistant | 2000 Fowler Grove Blvd Fl 3, Winter Garden, FL 34787-5050 | 2005-07-05 |
| 1043788813 | Vlad Richko | Physician Assistant | 3724 Winter Garden Vineland Rd Bldg 2, Winter Garden, FL 34787 | 2018-11-09 |
| 1043720782 | Laura Catherine Mendoza | Physician Assistant | 3131 Daniels Rd Ste 106, Winter Garden, FL 34787-7013 | 2017-10-09 |
| 1790213692 | Wesley Villanueva | Physician Assistant | 13275 W Colonial Dr, Winter Garden, FL 34787-3984 | 2017-05-23 |
| 1508212457 | Jessica L Cohn | Physician Assistant | 2000 Fowler Grove Blvd Fl 3, Winter Garden, FL 34787 | 2016-05-10 |
| 1851415301 | Krista Marie Rivera | Physician Assistant | 213 S Dillard St, Winter Garden, FL 34787-3596 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295525 | Asahel Romero | Physician Assistant | 13228 Canna Lily Dr, Orlando, FL 32824-5067 | 2020-11-07 |
| 1629679360 | Samantha Lee Zavada | Physician Assistant | 9459 Silver Pine Loop, Fort Myers, FL 33967-5152 | 2020-11-07 |
| 1235730177 | Emily Figueroa Vega | Physician Assistant | 1920 Nw 97th Ave, Coral Springs, FL 33071-5950 | 2020-11-06 |
| 1922609114 | Jeannine Castaneda Calderon | Physician Assistant | 816 Arbor Pointe Ave, Minneola, FL 34715-6052 | 2020-11-04 |
| 1962003178 | Mohammed Bilal Sheikh | Physician Assistant | 2920 Ne 207th St Ste 901, Miami, FL 33180-1444 | 2020-11-04 |
| 1891396131 | Whiplashmd, LLC | Physician Assistant | 940 Centre Cir Ste 1018, Altamonte Springs, FL 32714-7242 | 2020-11-03 |
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1356941504 | Kelsey Alexandra Leon | Physician Assistant | 5033 W Laurel St, Tampa, FL 33607-3855 | 2020-10-27 |
| Find all providers with the same taxonomy | ||||
| City | WINTER GARDEN |
| Zip Code | 34787 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.