Provider Demographics
NPI:1104037522
Name:ELHAMMADY, MOHAMED SAMY ADEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED SAMY
Middle Name:ADEL
Last Name:ELHAMMADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4943
Practice Address - Street 1:2727 W. MARTIN LUTHER KING JR. BLVD
Practice Address - Street 2:SUITE 460
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7144
Practice Address - Country:US
Practice Address - Phone:813-879-4328
Practice Address - Fax:813-443-8152
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110382207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFG811YMedicare PIN