Provider Demographics
NPI:1720227697
Name:LEMELMAN, ELLIOT NMI
Entity Type:Individual
Prefix:MR
First Name:ELLIOT
Middle Name:NMI
Last Name:LEMELMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ELLIOT
Other - Middle Name:
Other - Last Name:LEMELMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPHCP
Mailing Address - Street 1:210 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2913
Mailing Address - Country:US
Mailing Address - Phone:954-964-0048
Mailing Address - Fax:
Practice Address - Street 1:2730 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4808
Practice Address - Country:US
Practice Address - Phone:954-921-8696
Practice Address - Fax:954-921-6559
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist