Healthcare Provider Details

I. General information

NPI: 1114856549
Provider Name (Legal Business Name): ELITE ENDOCRINE AND METABOLISM CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 E ALTAMONTE DR STE 202
ALTAMONTE SPRINGS FL
32701-4810
US

IV. Provider business mailing address

616 E ALTAMONTE DR STE 202
ALTAMONTE SPRINGS FL
32701-4810
US

V. Phone/Fax

Practice location:
  • Phone: 321-333-9213
  • Fax: 321-972-5047
Mailing address:
  • Phone: 321-333-9213
  • Fax: 321-972-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: KWAME SAFO NTIM
Title or Position: OWNER
Credential: MD
Phone: 443-285-9293