Individual
ELKA JEANINE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-8544
(321) 434-3438
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(214) 348-5443
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME103198
FL
2084V0102X
Vascular Neurology Physician
81808
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
QW697
HFMG MA
FL
Enumeration date
06/01/2007
Last updated
05/30/2023
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