Provider Demographics
NPI:1881012599
Name:ELITE COMMUNITY HEALTH CARE CENTER INC
Entity Type:Organization
Organization Name:ELITE COMMUNITY HEALTH CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGLADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-254-9085
Mailing Address - Street 1:876 W SUGARLAND HWY
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-2704
Mailing Address - Country:US
Mailing Address - Phone:863-805-0317
Mailing Address - Fax:863-805-0807
Practice Address - Street 1:876 W SUGARLAND HWY
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-2704
Practice Address - Country:US
Practice Address - Phone:863-805-0317
Practice Address - Fax:863-805-0807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty