Provider Demographics
NPI:1346754058
Name:ELITE HOSPITALISTS, LLC
Entity Type:Organization
Organization Name:ELITE HOSPITALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:772-249-0260
Mailing Address - Street 1:579 NW LAKE WHITNEY PLACE
Mailing Address - Street 2:101
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1622
Mailing Address - Country:US
Mailing Address - Phone:772-249-0260
Mailing Address - Fax:772-249-0137
Practice Address - Street 1:579 NW LAKE WHITNEY PLACE
Practice Address - Street 2:101
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1622
Practice Address - Country:US
Practice Address - Phone:772-249-0260
Practice Address - Fax:772-249-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7680208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty