Provider Demographics
NPI:1477854891
Name:CIRIL, ELIE (MD)
Entity Type:Individual
Prefix:
First Name:ELIE
Middle Name:
Last Name:CIRIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 SHERIDAN ST
Mailing Address - Street 2:STE B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3559
Mailing Address - Country:US
Mailing Address - Phone:954-966-3018
Mailing Address - Fax:954-966-5249
Practice Address - Street 1:4060 SHERIDAN ST
Practice Address - Street 2:STE B
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3559
Practice Address - Country:US
Practice Address - Phone:954-966-3018
Practice Address - Fax:954-966-5249
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108779207RN0300X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14CL7OtherBCBS FL
FL14CL7OtherBCBS FL