Provider Demographics
NPI:1407368376
Name:EL CHARIF, SUHYB
Entity Type:Individual
Prefix:
First Name:SUHYB
Middle Name:
Last Name:EL CHARIF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 LAKE ALBERT DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5997
Mailing Address - Country:US
Mailing Address - Phone:786-955-5117
Mailing Address - Fax:
Practice Address - Street 1:7617 LAKE ALBERT DR
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-5997
Practice Address - Country:US
Practice Address - Phone:786-955-5117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician