MEDICARE: ELITEHEALTH PRIMARY CARE GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1003175324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITEHEALTH PRIMARY CARE GROUP

Provider Business Mailing Address
First Line	:	1601 N PALM AVE STE 109
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-3240
Country	:	US
Telephone Number	:	954-432-1511
Fax Number	:	954-432-5195

Provider Business Practice Location Address
First Line	:	1601 N PALM AVE STE 109
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-3240
Country	:	US
Telephone Number	:	954-432-1511
Fax Number	:	954-432-5195

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	ALICIA LEDO
Credential	:
Telephone Number	:	305-672-9989

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	05/07/2012

Similar Medicare Providers

1801151899 — WILLIAM LAZARO NAVARRO M.D.
Practice Location Address:

1601 N PALM AVE STE 101
PEMBROKE PINES, FL
33026-3240

Practice Phone: 954-436-6660
Practice Fax:

1386646966 — DR. JUAN CARLOS RODRIGUEZ M.D.
Practice Location Address:

1601 N PALM AVE , SUITE 109
PEMBROKE PINES, FL
33026-3240

Practice Phone: 954-271-0411
Practice Fax: 954-206-0111

1366407868 — MIAN A HASAN MD
Practice Location Address:

1601 N PALM AVE STE 101
PEMBROKE PINES, FL
33026-3240

Practice Phone: 954-436-6660
Practice Fax: 954-436-6655

1245554823 — MICHELE MORRISON INTERNAL MEDICINE INC
Practice Location Address:

1601 N PALM AVE STE 101
PEMBROKE PINES, FL
33026-3240

Practice Phone: 954-438-0033
Practice Fax: 954-438-4417

1548606437 — EDUARDO ANDRE MD
Practice Location Address:

1601 N PALM AVE STE 109
PEMBROKE PINES, FL
33026-3240

Practice Phone: 954-271-0411
Practice Fax: 954-901-2727

1851729982 — GREENLIFE INTENSIVE OUTPATIENT PROGRAM LLC
Practice Location Address:

1601 N PALM AVE STE 106
PEMBROKE PINES, FL
33026-3240

Practice Phone: 954-854-3053
Practice Fax:

Directions to “ELITEHEALTH PRIMARY CARE GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.