Elias M Gizaw, M.D.
Psychiatry & Neurology, Neurology in Lake Mary, FL. Individual provider (NPI-1).
NPI number1609879006
StatusActive
Last updated in NPPESMay 19, 2021
Details
- NPI
- 1609879006
- Entity type
- Individual (NPI-1)
- Name
- Elias M Gizaw
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 31, 2005
- Certification date
- May 19, 2021
- Last updated
- May 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | ME67379 | FL | Yes |
| 174400000X | Specialist | ME67379 | FL |
Practice location
755 Stirling Center PlLake Mary, FL 32746-5714
Phone 407-333-1718 · Fax 407-333-1633
Mailing address
755 Stirling Center PlLake Mary, FL 32746-5714
Phone 407-333-1718 · Fax 407-333-1633
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