Healthcare Provider Details

I. General information

NPI: 1740273713
Provider Name (Legal Business Name): EIMAN ELSAYED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 10/15/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 SAND MINE RD
DAVENPORT FL
33897-3402
US

IV. Provider business mailing address

2516 SAND MINE RD
DAVENPORT FL
33897-3402
US

V. Phone/Fax

Practice location:
  • Phone: 863-232-5527
  • Fax: 863-438-2776
Mailing address:
  • Phone: 863-232-5527
  • Fax: 863-438-2776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME93032
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: