Organization
NOEL L. ELGUT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEELAH CHAMPION (PRACTICE ADMINISTRATOR)
(954) 463-4761
Entity
Organization
Contact information
Practice address
6333 N FEDERAL HWY STE 401, FORT LAUDERDALE, FL 33308-1909
(954) 463-4761
(954) 463-4763
Mailing address
6333 N FEDERAL HWY STE 401, FORT LAUDERDALE, FL 33308-1909
(954) 463-4761
(954) 463-4763
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063637100
—
FL
05
—
106747100
—
FL
Enumeration date
12/01/2020
Last updated
12/01/2020
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