Organization
ELITEHEALTH PRIMARY CARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA LEDO (CREDENTIALING COORDINATOR)
(305) 672-9989
Entity
Organization
Contact information
Practice address
1601 N PALM AVE STE 109, PEMBROKE PINES, FL 33026-3240
(954) 432-1511
(954) 432-5195
Mailing address
1601 N PALM AVE STE 109, PEMBROKE PINES, FL 33026-3240
(954) 432-1511
(954) 432-5195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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