Provider Demographics
NPI:1629607239
Name:AMIN, SHERIF MAGDY
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:MAGDY
Last Name:AMIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 E HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-4528
Mailing Address - Country:US
Mailing Address - Phone:813-579-1769
Mailing Address - Fax:813-305-7907
Practice Address - Street 1:3128 E HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4528
Practice Address - Country:US
Practice Address - Phone:813-579-1769
Practice Address - Fax:813-305-7907
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME158719207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine