Provider Demographics
NPI:1639521800
Name:ELWANY, MOHAMED SAMY (AUD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:SAMY
Last Name:ELWANY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E ALTAMONTE DRIVE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-331-8883
Mailing Address - Fax:407-263-3098
Practice Address - Street 1:600 E ALTAMONTE DRIVE
Practice Address - Street 2:SUITE 1700
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-331-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2019231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist