Healthcare Provider Details

I. General information

NPI: 1740118330
Provider Name (Legal Business Name): EGH PROFESSIONAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19131 S SAINT ANDREWS DR
HIALEAH FL
33015-2331
US

IV. Provider business mailing address

19131 S SAINT ANDREWS DR
HIALEAH FL
33015-2331
US

V. Phone/Fax

Practice location:
  • Phone: 305-206-4111
  • Fax:
Mailing address:
  • Phone: 305-206-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ELENA HADDAD
Title or Position: OWNER
Credential:
Phone: 305-206-4111