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General NPI Number Information
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NPI Number | 1053705616
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Entity Type | Individual
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Provider Name | AMR ELZEIDY PT
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Gender | Male
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Dates
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Enumeration Date | 03/22/2015
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | 300 WILSHIRE BLVD STE 208
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City | CASSELBERRY
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State | FL
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Zip | 32707-5369
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Country | US
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Telephone | 407-406-2267
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Fax |
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Provider Business Mailing Address
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Address Line | 4488 LOWER PARK RD APT 3310
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City | ORLANDO
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State | FL
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Zip | 32814
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Country | US
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Telephone | 407-406-2267
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT27131
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License Number State | FL
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