Provider Demographics
NPI:1215344213
Name:EL KHOLY, AMIRA (APRN)
Entity type:Individual
Prefix:
First Name:AMIRA
Middle Name:
Last Name:EL KHOLY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 SAND CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1205
Mailing Address - Country:US
Mailing Address - Phone:305-310-3822
Mailing Address - Fax:
Practice Address - Street 1:1065 NE 125TH ST STE 206
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5833
Practice Address - Country:US
Practice Address - Phone:305-891-0050
Practice Address - Fax:305-891-0497
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9310148163W00000X, 163WC0200X
FLAPRN9310148363LF0000X, 363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily