Provider Demographics
NPI:1639864846
Name:ELLE CLINIQUES LLC
Entity Type:Organization
Organization Name:ELLE CLINIQUES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NUELA
Authorized Official - Middle Name:UCHE
Authorized Official - Last Name:UMEH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, APRN
Authorized Official - Phone:407-751-0025
Mailing Address - Street 1:PO BOX 451898
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34745-1898
Mailing Address - Country:US
Mailing Address - Phone:407-751-0025
Mailing Address - Fax:
Practice Address - Street 1:115 E LANCASTER RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-6689
Practice Address - Country:US
Practice Address - Phone:407-751-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty