Individual provider Active NPI

Elenora Vidal-Pascal

  • Gerontology Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1861952715
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11001913 Issued in FL
Practice address
2351 Phillips Rd
Tallahassee, FL 32308-5333
Phone
(850) 877-8166
Fax
(850) 877-0431
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11001913 FL Primary

Addresses

Primary practice location

2351 Phillips Rd
Tallahassee, FL 32308-5333

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
110802100MedicaidFL

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
I20190628001294 FL Practitioner - Nurse Practitioner 7911231642 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11001913FLMDGerontology Registered Nurse
APRN11001913FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince May 20, 2019 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

2351 Phillips Rd
Tallahassee, FL 32308
Phone (850) 877-8166

2626 Care Dr
Ste 200
Tallahassee, FL 32308
Phone (850) 219-5830

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1861952715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 PHILLIPS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085333",
            "telephone_number": "850-877-8166",
            "fax_number": "850-877-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL-PASCAL",
        "first_name": "ELENORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11001913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110802100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.