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Contact Information

WISSAM M ELFALLAL, D.O
305 MEMORIAL MEDICAL PKWY STE 505
DAYTONA BEACH, FL32117-5170
 Phone: 386-231-3540
 Fax: 386-231-3544
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for WISSAM M ELFALLAL · (Male)

NPI # 1730594805
Status Active
Credentials D.O
Entity Individual
Enumeration date 06/26/2014
Last updated 08/18/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # OS17401
  • MI License # 5101021284
Hospital affiliation(s)
  • BERT FISH MEDICAL CENTER - (Acute Care)
    401 PALMETTO ST
    NEW SMYRNA BEACH, FL 32170
  • FLORIDA HOSPITAL - (Acute Care)
    601 E ROLLINS ST
    ORLANDO, FL 32803
  • FLORIDA HOSPITAL FLAGLER - (Acute Care)
    60 MEMORIAL MEDICAL PKWY
    PALM COAST, FL 32164
  • FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER - (Acute Care)
    301 MEMORIAL MEDICAL PARKWAY
    DAYTONA BEACH, FL 32117
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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