Provider Demographics
NPI:1548243843
Name:ELGUT, NOEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:L
Last Name:ELGUT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:6333 N FEDERAL HWY
Mailing Address - Street 2:SUITE 401
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1907
Mailing Address - Country:US
Mailing Address - Phone:954-463-4761
Mailing Address - Fax:954-463-4763
Practice Address - Street 1:6333 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1907
Practice Address - Country:US
Practice Address - Phone:954-463-4761
Practice Address - Fax:954-463-4763
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME58120207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063637100Medicaid
FL10634BMedicare PIN
FL063637100Medicaid