=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629503750
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELAINE FELIX DPM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2017
-----------------------------------------------------
Last Update Date | 02/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1508 VILLAGE OAK LN
-----------------------------------------------------
City | KISSIMMEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34746-6558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-518-7747
-----------------------------------------------------
Fax | 877-810-6064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15815 SHADDOCK DR STE 130
-----------------------------------------------------
City | WINTER GARDEN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34787-5773
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-605-2321
-----------------------------------------------------
Fax | 407-671-4155
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | PO4157
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | PO4157
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------