Healthcare Provider Details
I. General information
NPI: 1700798303
Provider Name (Legal Business Name): ELAYA HEALTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 NE 169TH TER
MIAMI FL
33162-2632
US
IV. Provider business mailing address
284 PARK AVE
PASSAIC NJ
07055-4455
US
V. Phone/Fax
- Phone: 917-862-3003
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEHRI
SONGHORIAN
Title or Position: OWNER
Credential: MD
Phone: 917-862-3003