Provider Demographics
NPI:1629323001
Name:ELKHIDIR, HAMZA SAEED (MD)
Entity Type:Individual
Prefix:
First Name:HAMZA
Middle Name:SAEED
Last Name:ELKHIDIR
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 1:11252 SW KINGSLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2761
Mailing Address - Country:US
Mailing Address - Phone:215-715-7120
Mailing Address - Fax:
Practice Address - Street 1:11252 SW KINGSLAKE CIR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2761
Practice Address - Country:US
Practice Address - Phone:215-715-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1208252080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine