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NPI Code Detail

MEDICARE: ELIA KHALAF

MEDICARE:   ELIA  KHALAF
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1669017927
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIA KHALAF
Provider Business Mailing Address
First Line : 10611 NE 10TH PL
Second Line :
City : MIAMI SHORES
State : FL
Zip : 33138-2103
Country : US
Telephone Number : 305-764-2020
Fax Number :
Provider Business Practice Location Address
First Line : 1152 N UNIVERSITY DR
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33024-5000
Country : US
Telephone Number : 954-639-7345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2019
Last Update Date : 11/23/2020

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Directions to “ ELIA KHALAF ” Practice Location

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