Provider Demographics
NPI:1497473151
Name:ZABLAH, ELIAS (PA)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:
Last Name:ZABLAH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SE 3RD ST APT 205
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4038
Mailing Address - Country:US
Mailing Address - Phone:305-439-2499
Mailing Address - Fax:
Practice Address - Street 1:7630 SW 34TH MNR STE 100
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1988
Practice Address - Country:US
Practice Address - Phone:954-991-6810
Practice Address - Fax:954-991-6811
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116304363A00000X
FLPA91196304363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant