Provider Demographics
NPI:1861621500
Name:HADDAD, ELYANE NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:ELYANE
Middle Name:NICOLE
Last Name:HADDAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIANE
Other - Middle Name:NICOLE
Other - Last Name:HADDAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:411 SW 29TH CT APT 6B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2837
Mailing Address - Country:US
Mailing Address - Phone:865-591-9540
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-666-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104788208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice