=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154173979
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EL ELYON MEDPSYCH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2024
-----------------------------------------------------
Last Update Date | 07/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1501 BELVEDERE RD STE 500
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33406-1524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-879-4242
-----------------------------------------------------
Fax | 561-828-2884
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8988 ALEXANDRA CIR STE 207
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-6438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-283-9247
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MR. ZAIN ALI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-879-4242
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------