Provider Demographics
NPI:1598808180
Name:ELKAYAM, LIOR URIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LIOR
Middle Name:URIEL
Last Name:ELKAYAM
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 1:390 S STATE ROAD 7 STE 249
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6718
Mailing Address - Country:US
Mailing Address - Phone:954-743-5522
Mailing Address - Fax:954-743-5632
Practice Address - Street 1:390 S STATE ROAD 7 STE 249
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-6718
Practice Address - Country:US
Practice Address - Phone:954-743-5522
Practice Address - Fax:954-743-5632
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236526207R00000X
FLME103075207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9361592OtherAETNA
FL002257600Medicaid
FL9361592OtherAETNA