Healthcare Provider Details

I. General information

NPI: 1306387659
Provider Name (Legal Business Name): CHRISTINA ELZAHABY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2017
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2338 IMMOKALEE RD STE 186
NAPLES FL
34110-1445
US

IV. Provider business mailing address

2085 HIGHPOINTE DR UNIT 207
CORONA CA
92879-5956
US

V. Phone/Fax

Practice location:
  • Phone: 239-431-8739
  • Fax:
Mailing address:
  • Phone: 951-710-4726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME145674
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: