Provider Demographics
NPI:1881644979
Name:ELBUALY, SEIF (MD)
Entity Type:Individual
Prefix:DR
First Name:SEIF
Middle Name:
Last Name:ELBUALY
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 1:800 MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2304
Mailing Address - Country:US
Mailing Address - Phone:561-955-4600
Mailing Address - Fax:561-955-5128
Practice Address - Street 1:800 MEADOWS RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2304
Practice Address - Country:US
Practice Address - Phone:561-955-4600
Practice Address - Fax:619-555-1285
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067941207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2174908Medicaid
FL378319700Medicaid
FL27772AMedicare ID - Type Unspecified
FLG15123Medicare UPIN
LA2174908Medicaid