Provider Demographics
NPI:1275627895
Name:ELISME, JUNIE FLEURINORD (MD)
Entity type:Individual
Prefix:
First Name:JUNIE
Middle Name:FLEURINORD
Last Name:ELISME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JUNIE
Other - Middle Name:
Other - Last Name:FLEURINORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-967-6400
Mailing Address - Fax:954-965-7339
Practice Address - Street 1:4400 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5862
Practice Address - Country:US
Practice Address - Phone:954-486-8983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 70067208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250010800Medicaid
FLH40206 0001Medicare UPIN