Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME116939 | FL |
N | 208000000X | Pediatrician | ME116939 | FL |
NPI | 1144431891 |
---|---|
Provider Name | Nancy E Elazab |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 22/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07919 | (05) | LA |