MEDICARE: ELITE HEALTH MEDICAL CENTERS

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	:	1215572920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE HEALTH MEDICAL CENTERS

Provider Business Mailing Address
First Line	:	1700 79TH STREET CSWY STE 120
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-4197
Country	:	US
Telephone Number	:	305-726-2177
Fax Number	:	305-726-2209

Provider Business Practice Location Address
First Line	:	4125 S TAMIAMI TRL STE 2
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34293-5121
Country	:	US
Telephone Number	:	941-584-9201
Fax Number	:	941-584-9202

Authorized Official
Title or Position	:	CEO
Name	:	STEVEN SCHNUR
Credential	:	MD
Telephone Number	:	786-256-9657

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	11/18/2019

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Directions to “ELITE HEALTH MEDICAL CENTERS ” Practice Location

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