Elitehealth Primary Care Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ELITEHEALTH PRIMARY CARE GROUP

Practice address

1601 N Palm Ave Ste 109
Pembroke Pines, FL 33026-3240

Phone

(954) 432-1511

Fax

(954) 432-5195

NPI assigned

May 7, 2012

Organization subpart

No

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

Authorized official

Name

Alicia Ledo

Title

Credentialing Coordinator

Phone

(305) 672-9989

Specialties & licenses 1

Addresses

Tax ID family

Elite Health Primary Care PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elite Health Primary Care PA

  • Internal Medicine Physician
  • Miami Beach, FL
  • NPI 1831425073
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1003175324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE STE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263240",
            "telephone_number": "954-432-1511",
            "fax_number": "954-432-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE STE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263240",
            "telephone_number": "954-432-1511",
            "fax_number": "954-432-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITEHEALTH PRIMARY CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-07",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "LEDO",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "305-672-9989"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Care Pharmacy Corp
• Elite Diagnostics I Inc
• Elite Diagnostix, Inc.
• Elite Family Home Care Inc
• Elite Health and Fitness Co.,
• Rosemary Eljaua, ED.S.
• Marquitta Elliott, LDO
• Cara L.Eigh Elmstrom, PA-C
• Elsy M. Coronado, MD, PA
• Emad Ekladios M D P a

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.