Provider Demographics
NPI:1316030182
Name:ELITE CONSULTING & MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:ELITE CONSULTING & MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-403-7852
Mailing Address - Street 1:701 NW 57TH AVE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3275
Mailing Address - Country:US
Mailing Address - Phone:305-403-7852
Mailing Address - Fax:305-403-7853
Practice Address - Street 1:701 NW 57TH AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3275
Practice Address - Country:US
Practice Address - Phone:305-403-7852
Practice Address - Fax:305-403-7853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLK9713174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9713Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER