Organization
ELITE MEDICAL PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCINE COSTELLO (ACCOUNTANT)
(772) 528-9991
Entity
Organization
Contact information
Practice address
1701 SE HILLMOOR DR # 17, PORT SAINT LUCIE, FL 34952-7552
(772) 207-0697
Mailing address
1701 SE HILLMOOR DR # 17, PORT SAINT LUCIE, FL 34952-7552
(772) 207-0697
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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