Provider Demographics
NPI:1437186970
Name:EL-GENDY, ALAA A (MD, MSC, FCCP)
Entity Type:Individual
Prefix:DR
First Name:ALAA
Middle Name:A
Last Name:EL-GENDY
Suffix:
Gender:M
Credentials:MD, MSC, FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3445
Mailing Address - Street 2:
Mailing Address - City:N FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33918-3445
Mailing Address - Country:US
Mailing Address - Phone:239-369-3333
Mailing Address - Fax:239-369-4837
Practice Address - Street 1:2625 LEE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971
Practice Address - Country:US
Practice Address - Phone:239-369-3333
Practice Address - Fax:239-369-4837
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30424207RP1001X
PAMD057737L207RP1001X
NY222371-1207RP1001X
NJ25MA06121800207RP1001X
FLME85931207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62720OtherBCBS OF FL
FL266038500Medicaid
FL62720OtherBCBS OF FL
FLK4103Medicare ID - Type Unspecified