MEDICARE: ELIE CIRIL M.D.

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	ME108779	FL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RN0300X	Nephrology Physician	ME108779	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14CL7	OTHER	FL	BCBS FL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477854891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIE CIRIL M.D.

Provider Business Mailing Address
First Line	:	3854 SHERIDAN ST STE A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3630
Country	:	US
Telephone Number	:	954-966-3018
Fax Number	:	954-966-5249

Provider Business Practice Location Address
First Line	:	3854 SHERIDAN ST STE A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3630
Country	:	US
Telephone Number	:	954-966-3018
Fax Number	:	954-966-5249

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

Provider Enumeration Date	:	11/17/2010
Last Update Date	:	05/21/2024

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