MEDICARE: EL ELYON MEDPSYCH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1154173979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL ELYON MEDPSYCH SERVICES

Provider Business Mailing Address
First Line	:	8988 ALEXANDRA CIR STE 207
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6438
Country	:	US
Telephone Number	:	561-283-9247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 BELVEDERE RD STE 500
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-1524
Country	:	US
Telephone Number	:	561-879-4242
Fax Number	:	561-828-2884

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. ZAIN ALI
Credential	:
Telephone Number	:	561-879-4242

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	07/09/2025

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