Provider Demographics
NPI:1972195279
Name:ELITE INFUSION SERVICES LLC
Entity Type:Organization
Organization Name:ELITE INFUSION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:ABREGO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:561-766-0612
Mailing Address - Street 1:560 VILLAGE BLVD STE 325A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1945
Mailing Address - Country:US
Mailing Address - Phone:561-766-0612
Mailing Address - Fax:
Practice Address - Street 1:560 VILLAGE BLVD STE 325A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1945
Practice Address - Country:US
Practice Address - Phone:561-766-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health