Healthcare Provider Details

I. General information

NPI: 1023269438
Provider Name (Legal Business Name): ELBA ENER MASID M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 MURRELL RD STE 102
ROCKLEDGE FL
32955-4569
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 200
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 321-632-7520
  • Fax: 321-632-8092
Mailing address:
  • Phone: 727-322-3439
  • Fax: 800-928-7449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME102282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: