Healthcare Provider Details

I. General information

NPI: 1437303658
Provider Name (Legal Business Name): ELIAS CHOUSLEB MIZRAHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ELIAS CHOUSLEB MIZRAHI M.D.

II. Dates (important events)

Enumeration Date: 11/14/2008
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 NE 214TH ST STE 817
MIAMI FL
33180-1270
US

IV. Provider business mailing address

2308 BISSONNET ST UNIT B
HOUSTON TX
77005-1155
US

V. Phone/Fax

Practice location:
  • Phone: 305-539-0410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number104145
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: