Provider Demographics
NPI:1154718302
Name:CARGES, ELIZABETH (PHD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CARGES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N MAITLAND AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4482
Mailing Address - Country:US
Mailing Address - Phone:407-628-5354
Mailing Address - Fax:407-628-0254
Practice Address - Street 1:500 N MAITLAND AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4482
Practice Address - Country:US
Practice Address - Phone:407-628-5354
Practice Address - Fax:407-628-0254
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist