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Individual

ELIAS M GIZAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
755 STIRLING CENTER PL, LAKE MARY, FL 32746-5714
(407) 333-1718
(407) 333-1633
Mailing address
755 STIRLING CENTER PL, LAKE MARY, FL 32746-5714
(407) 333-1718
(407) 333-1633

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
ME67379
FL
2084N0400X
Neurology Physician
Primary
ME67379
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
377287000
FL
Enumeration date
05/31/2005
Last updated
05/19/2021
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