Healthcare Provider Details

I. General information

NPI: 1952645475
Provider Name (Legal Business Name): ELARYA BATKILIN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2012
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 THREE ISLANDS BLVD APT.717
HALLANDALE BEACH FL
33009-2887
US

IV. Provider business mailing address

500 THREE ISLANDS BLVD APT.717
HALLANDALE BEACH FL
33009-2887
US

V. Phone/Fax

Practice location:
  • Phone: 954-802-1680
  • Fax:
Mailing address:
  • Phone: 954-802-1680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ6099
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: