Provider Demographics
NPI:1548052517
Name:ELLEORHIM MEDICAL GROUP LLC
Entity type:Organization
Organization Name:ELLEORHIM MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:CARLINE
Authorized Official - Last Name:OSEH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN,
Authorized Official - Phone:954-889-1181
Mailing Address - Street 1:20523 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2381
Mailing Address - Country:US
Mailing Address - Phone:954-889-1181
Mailing Address - Fax:
Practice Address - Street 1:20348 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-2503
Practice Address - Country:US
Practice Address - Phone:954-889-1181
Practice Address - Fax:786-930-4046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELLEORHIM MENTAL WELLBEING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty