Provider Demographics
NPI:1316725849
Name:ABOU KHEIR ABOU KHEIR, ELIAS FOUAD (SA-C)
Entity type:Individual
Prefix:
First Name:ELIAS
Middle Name:FOUAD
Last Name:ABOU KHEIR ABOU KHEIR
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15006 SW 104TH ST APT 2510
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3264
Mailing Address - Country:US
Mailing Address - Phone:786-695-8090
Mailing Address - Fax:
Practice Address - Street 1:15006 SW 104TH ST APT 2510
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3264
Practice Address - Country:US
Practice Address - Phone:786-695-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-608246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant