Provider Demographics
NPI:1720296742
Name:ELLIOTT, JOSHUA N (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:N
Last Name:ELLIOTT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 5TH ST S STE C640
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4804
Mailing Address - Country:US
Mailing Address - Phone:727-767-4393
Mailing Address - Fax:727-767-8668
Practice Address - Street 1:601 5TH ST S STE C640
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-4393
Practice Address - Fax:727-767-8668
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27559207W00000X
FLME112639207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology