Provider Demographics
NPI:1265024087
Name:ELITE PPEC INC
Entity Type:Organization
Organization Name:ELITE PPEC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YENI
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-314-1912
Mailing Address - Street 1:795 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-5401
Mailing Address - Country:US
Mailing Address - Phone:754-263-2925
Mailing Address - Fax:
Practice Address - Street 1:795 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-5401
Practice Address - Country:US
Practice Address - Phone:754-263-2925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care