# ELEMY IOP LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FL MC SPROUT 1 LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1083347868
- **Legal business name:** FL MC SPROUT 1 LLC
- **Authorized official:** YURY YAKUBCHYK (CEO)
- **Authorized official phone:** (833) 458-0386

## Contact information

- **Practice address:** 6303 BLUE LAGOON DR STE 400, MIAMI, FL 33126-6040
- **Practice address phone:** (833) 458-0386
- **Mailing address:** 6303 BLUE LAGOON DR STE 400, MIAMI, FL 33126-6040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 07/08/2022
- **Last updated:** 07/08/2022