MEDICARE: ELIAS JOSE MUALIN MD

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	207V00000X	Obstetrics & Gynecology Physician	ME86605	FL
2	207VG0400X	Gynecology Physician	ME86605	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0845933	OTHER	FL	PARITY HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	300151000	OTHER	FL	TRICARE
4	29130	OTHER	FL	BCBS
5	994795	OTHER	FL	NHP
6	291529	OTHER	FL	AVMED
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134290539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIAS JOSE MUALIN MD

Provider Business Mailing Address
First Line	:	450 N PARK RD
Second Line	:	SUITE 202
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5403
Country	:	US
Telephone Number	:	954-983-2101
Fax Number	:	954-983-2860

Provider Business Practice Location Address
First Line	:	450 N PARK RD
Second Line	:	SUITE 202
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5403
Country	:	US
Telephone Number	:	954-983-2101
Fax Number	:	954-983-2860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	04/10/2025

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Directions to “ ELIAS JOSE MUALIN MD” Practice Location

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