Individual provider Active NPI

Elizabeth Davide, PA-C

  • Medical Physician Assistant
  • Largo, FL
National Provider Identifier
1053148445
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9119487 Issued in FL
Practice address
12416 66TH St Ste a
Largo, FL 33773-3430
Phone
(727) 547-4700
Fax
(727) 394-8661
NPI assigned
Sep 18, 2024
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9119487 FL Primary

Addresses

Primary practice location

12416 66TH St Ste a
Largo, FL 33773-3430

Mailing address

12416 66TH St Ste a
Largo, FL 33773-3430
Phone (727) 547-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250217002549 FL Practitioner - Physician Assistant 2466972765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alexander Medical Group LLCGroup PAC ID 0547299836, 25 clinicians

Practice addresses (Care Compare)

12416 66TH St
Suite a
Largo, FL 33773-3430
Phone (727) 547-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9119487FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Medical Group LLC CurrentSince Aug 18, 2025 Accepting new patients

Locations

12416 66th St
Ste A
Largo, FL 33773
Phone 7275474700112

2438 Dr Ml King Jr St N
St Petersburg, FL 33704
Phone (727) 565-0740

Interoperability endpoints

  • Direct secure messaging: elizabeth.davide@3463.securemail.prognocis.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1053148445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12416 66TH ST STE A",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733430",
            "telephone_number": "727-547-4700",
            "fax_number": "727-394-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12416 66TH ST STE A",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733430",
            "telephone_number": "727-547-4700",
            "fax_number": "727-394-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDE",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9119487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.