Provider Demographics
NPI:1144497546
Name:ELIZEE, DARNLEY GEORGES (PSYD)
Entity type:Individual
Prefix:DR
First Name:DARNLEY
Middle Name:GEORGES
Last Name:ELIZEE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4947 SW 167TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4909
Mailing Address - Country:US
Mailing Address - Phone:954-367-5041
Mailing Address - Fax:
Practice Address - Street 1:12555 ORANGE DR STE 208
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:054-636-2495
Practice Address - Fax:954-237-7573
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15039103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02270253Medicaid