Provider Demographics
NPI:1073693313
Name:ELIDEMIR, OKAN (MD)
Entity Type:Individual
Prefix:
First Name:OKAN
Middle Name:
Last Name:ELIDEMIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-5985
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:5153 NORTH 9TH AVE.
Practice Address - Street 2:NEMOURS CHILDREN'S CLINIC
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8785
Practice Address - Country:US
Practice Address - Phone:850-473-4516
Practice Address - Fax:850-473-4516
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL0006122080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology