Individual
DR. NIDAL S ELIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
9250 BAYMEADOWS RD, SUITE #300, JACKSONVILLE, FL 32256-1883
(904) 731-2120
(904) 731-9235
Mailing address
9250 BAYMEADOWS RD, SUITE #300, JACKSONVILLE, FL 32256-1883
(904) 731-2120
(904) 731-9235
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11583
FL
1223P0700X
Prosthodontics
Primary
11583
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59-3051738
FEDERAL TAX I. D. NUMBER
FL
Enumeration date
07/13/2006
Last updated
08/11/2010
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