Provider Demographics
NPI:1275370512
Name:TIMOFTI, ELENA (APRN)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:TIMOFTI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:PRUGLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:521 W STATE ROAD 434 STE 307&308
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4984
Mailing Address - Country:US
Mailing Address - Phone:321-841-6444
Mailing Address - Fax:321-842-1955
Practice Address - Street 1:521 W STATE ROAD 434 STE 307&308
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4984
Practice Address - Country:US
Practice Address - Phone:321-841-6444
Practice Address - Fax:321-842-1955
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032970363LF0000X
FLAPRN11032970363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily