Provider Demographics
NPI:1154494912
Name:REHL, ELENA TERESA (MD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:TERESA
Last Name:REHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4700 WATERS AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6220
Mailing Address - Country:US
Mailing Address - Phone:912-350-2700
Mailing Address - Fax:912-350-2715
Practice Address - Street 1:1411 N FLAGLER DR STE 5000
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3410
Practice Address - Country:US
Practice Address - Phone:561-655-6622
Practice Address - Fax:561-655-6623
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA070415208600000X, 2086X0206X
TNMD48118208600000X, 2086X0206X
FLME1388982086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGA1516Medicaid
GA003135909AMedicaid
GAP01199006OtherRAILROAD MEDICARE
GA003135909BMedicaid
GAP01199006OtherRAILROAD MEDICARE