| Doctor Name: | DR. ELIZABETH TATUM ATHANS |
| NPI Number: | 1902057417 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | ME109486 |
| Business Practice Address: | 9145 Narcoossee Rd Suite 103 Orlando, FL - 328275768 |
| Business Phone Number: | 4072432040 |
| Business Fax Number: | 4072432043 |
| Mailing Address: | P.o. Box 191, ROCKLAND |
| State: | DE |
| Postal Code: | 197320191 |
| Phone Number: | 3026516212 |
| Fax Number: | 3026514945 |
| NPI Enumeration Date: | 10/02/2008 |
| NPI Last Update Date: | 05/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME109486 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |