Individual provider Active NPI

Elizabeth Anne Vitarbo, MD

  • Neurological Surgery Physician
  • Gainesville, FL
National Provider Identifier
1235169079
Registry record updated Jun 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME93374 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-1370
Phone
(352) 273-9000
Fax
(352) 392-8413
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME93374 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-1370

Mailing address

PO Box 100265
Gainesville, FL 32610-0265
Phone (352) 273-9000

Other practice location 1

1801 W Sample Rd Ste 101
Deerfield Beach, FL 33064-1370
Phone (954) 888-3800

Other practice location 2

311 N Clyde Morris Blvd
Daytona Beach, FL 32114-2781
Phone (386) 255-2340

Other identifiers 2

IdentifierTypeStateIssuer
2760819-00MedicaidFL
406220970AMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061027000061 FL Practitioner - NeurosurgeryPractitioner - Critical Care (Intensivists) 0345209128 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME93374FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Neurological Surgery CurrentSince Jun 1, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 1, 2023 Accepting new patients

Locations

311 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 241-1020

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687564800000",
    "number": "1235169079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100265",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100265",
            "telephone_number": "352-273-9000",
            "fax_number": "352-392-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326101370",
            "telephone_number": "352-273-9000",
            "fax_number": "352-392-8413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Sample Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "330641370",
            "country_code": "US",
            "telephone_number": "954-888-3800",
            "fax_number": "954-888-3808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 N Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142781",
            "country_code": "US",
            "telephone_number": "386-255-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITARBO",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME93374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2760819-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406220970A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.