Provider Demographics
NPI:1033906565
Name:ELYAEI, LANA
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:ELYAEI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5881 BRIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3250
Mailing Address - Country:US
Mailing Address - Phone:954-253-6644
Mailing Address - Fax:
Practice Address - Street 1:5881 BRIGHTON LN
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-3250
Practice Address - Country:US
Practice Address - Phone:954-253-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter