Healthcare Provider Details

I. General information

NPI: 1811417017
Provider Name (Legal Business Name): NADIA ELIAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W LEOTA ST
NORTH PLATTE NE
69101-6576
US

IV. Provider business mailing address

6850 LAKE NONA BLVD
ORLANDO FL
32827-7408
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-4400
  • Fax: 308-534-7675
Mailing address:
  • Phone: 321-697-1730
  • Fax: 407-518-3923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number34095
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: