Provider Demographics
NPI:1932586310
Name:ELDAYRIE, CARLEIGH N (MD)
Entity Type:Individual
Prefix:
First Name:CARLEIGH
Middle Name:N
Last Name:ELDAYRIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 PORTER RD STE 207
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-8915
Mailing Address - Country:US
Mailing Address - Phone:407-635-3013
Mailing Address - Fax:407-636-7844
Practice Address - Street 1:17000 PORTER RD STE 207
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-8915
Practice Address - Country:US
Practice Address - Phone:407-635-3013
Practice Address - Fax:407-636-7844
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME141747208000000X
NC2018-01886208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105815000Medicaid