Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elizabeth Mathew Pullukala

Individual provider Nurse Practitioner · NPI 1174305742

Elizabeth Mathew Pullukala is a Nurse Practitioner in Jacksonville, Florida. Qualified in 2022, 4 years ago. Practices with Vip Specialties of Florida, a 26-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

2098 Knottingham Trace Ln
Jacksonville, FL 32246-1396
Phone: (904) 525-3684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence APRN11025870 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence 11025870 (FL)

Record details

NPI number1174305742
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 18, 2023
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026
Mailing address2098 Knottingham Trace Ln, Jacksonville, FL 32246-1396

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Vip Specialties Of Florida — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Jacksonville