Provider Demographics
NPI:1720254568
Name:BELFORT, ELSIE P (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ELSIE
Middle Name:P
Last Name:BELFORT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELSIE
Other - Middle Name:P
Other - Last Name:REMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:9254 PLANTATION ESTATES DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:954-478-0553
Mailing Address - Fax:561-345-3382
Practice Address - Street 1:17145 HAMLIN BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-1759
Practice Address - Country:US
Practice Address - Phone:954-478-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3368202363LA2200X, 363LF0000X
NYF3018991363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0011182601Medicaid
FL001721700Medicaid