Healthcare Provider Details

I. General information

NPI: 1316366461
Provider Name (Legal Business Name): BRANDON M ELNEKAVEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 DOUGLAS RD STE 510
CORAL GABLES FL
33134-6100
US

IV. Provider business mailing address

2600 DOUGLAS RD STE 510
CORAL GABLES FL
33134-6100
US

V. Phone/Fax

Practice location:
  • Phone: 305-503-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number285018
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME161213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: