# ELIAS DERMATOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487042636
- **Authorized official:** DR. MATTHEW J ELIAS D.O. (MANAGER MEMBER)
- **Authorized official phone:** (415) 802-1310

## Contact information

- **Practice address:** 3100 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-4327
- **Practice address phone:** (415) 802-1310
- **Practice address fax:** (954) 771-0582
- **Mailing address:** 3100 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-4327
- **Mailing address phone:** (415) 802-1310
- **Mailing address fax:** (954) 771-0582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | OS9756 | FL | — |
| 207ND0101X | MOHS-Micrographic Surgery Physician | OS9756 | FL | — |
| 207ND0900X | Dermatopathology Physician | OS9756 | FL | — |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | OS9756 | FL | Yes |
| 207NP0225X | Pediatric Dermatology Physician | OS9756 | FL | — |
| 207NS0135X | Procedural Dermatology Physician | OS9756 | FL | — |

## Other

- **Enumeration date:** 12/22/2014
- **Last updated:** 12/13/2024