Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME139715 | FL |
NPI | 1003260316 |
---|---|
Provider Name | Elyse S Schrandt |
First Address | Pensacola, FL 32503-4747 |
Second Address | Pensacola, FL 32514-6039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2016 |
Last Update Date | 22/10/2019 |