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General NPI Number Information
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NPI Number | 1023693603
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Entity Type | Organization
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Legal Business Name | ELITE HEALTH ACCESS, LLC
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 02/14/2026
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Provider Practice Location Address
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Address Line | 807 SE 12TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2228
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Country | US
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Telephone | 305-306-2880
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Fax | 305-306-2889
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Provider Business Mailing Address
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Address Line | 807 SE 12TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2228
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Country | US
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Telephone | 305-306-2880
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Fax | 305-306-2889
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. AUDREA VAUGHAN
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Credential | DO
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Telephone | 305-306-2880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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