Provider Demographics
NPI:1194978569
Name:ERA, ELBYS (DPM)
Entity type:Individual
Prefix:
First Name:ELBYS
Middle Name:
Last Name:ERA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 NW 27 ST
Mailing Address - Street 2:STE 108
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1906
Mailing Address - Country:US
Mailing Address - Phone:786-662-3893
Mailing Address - Fax:786-662-3899
Practice Address - Street 1:10621 N KENDALL DR
Practice Address - Street 2:SUITE 213
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8708
Practice Address - Country:US
Practice Address - Phone:786-464-0631
Practice Address - Fax:786-762-2632
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3374213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002070800Medicaid
FL5884870048Medicare NSC
FLEG301ZMedicare PIN