Provider Demographics
NPI:1447271176
Name:MORIARTY, ELIZABETH J (CRNA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:J
Other - Last Name:ALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4918
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32802-4918
Mailing Address - Country:US
Mailing Address - Phone:407-581-9180
Mailing Address - Fax:865-560-7066
Practice Address - Street 1:225 E ROBINSON ST
Practice Address - Street 2:SUITE 130
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-4322
Practice Address - Country:US
Practice Address - Phone:407-581-9180
Practice Address - Fax:865-560-7066
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730627367500000X
FLARNP3242582367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG3554OtherBCBS
FL3063526 00Medicaid
FL0191720 00Medicaid
FL3063526 00Medicaid
FL0191720 00Medicaid