Organization
ELIAS MILGRAM M.D. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS MILGRAM M.D. (PRESIDENT)
(305) 490-8690
Entity
Organization
Contact information
Practice address
2875 NE 191ST ST, SUITE 604, AVENTURA, FL 33180-2801
(305) 932-3083
Mailing address
2875 NE 191ST ST, SUITE 604, AVENTURA, FL 33180-2801
(305) 932-3083
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME81124
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11340235
CAQH
—
05
—
264396100
—
FL
01
—
93507690023
AMA EDUC#
—
01
—
BM7022875
D.E.A.
—
Enumeration date
01/28/2015
Last updated
01/28/2015
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