| Doctor Name: | MRS. BEVERLY DORSON ELMORE |
| NPI Number: | 1063840569 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA9107359 |
| Business Practice Address: | 280 Farner Pl The Villages, FL - 321636066 |
| Business Phone Number: | 3526741710 |
| Business Fax Number: | 3526748910 |
| Mailing Address: | 1020 Lake Sumter Landing, THE VILLAGES |
| State: | FL |
| Postal Code: | 321626066 |
| Phone Number: | 3526748820 |
| Fax Number: | 3526748919 |
| NPI Enumeration Date: | 10/18/2013 |
| NPI Last Update Date: | 11/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9107359 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |