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General NPI Number Information
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NPI Number | 1538798004
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Entity Type | Organization
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Legal Business Name | VITALITY FOOT AND ANKLE INSTITUTE PLLC
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 26900 N LAKE PLEASANT PKWY STE 202
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City | PEORIA
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State | AZ
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Zip | 85383-1558
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Country | US
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Telephone | 623-254-7111
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Fax | 623-254-7100
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Provider Business Mailing Address
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Address Line | 26900 N LAKE PLEASANT PKWY STE 202
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City | PEORIA
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State | AZ
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Zip | 85383-1558
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Country | US
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Telephone | 623-254-7111
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Fax | 623-254-7100
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Authorized Official
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Title or Position | CEO
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Name | DR. YEHIA MOHAMED ELEBRASHI
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Credential | DPM
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Telephone | 623-396-9752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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