Provider Demographics
NPI:1679724272
Name:ABOUELMAGD, HALA (MD)
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:ABOUELMAGD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 BROWN CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-2043
Mailing Address - Country:US
Mailing Address - Phone:407-593-2883
Mailing Address - Fax:407-593-2884
Practice Address - Street 1:933 BROWN CHAPEL RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-2043
Practice Address - Country:US
Practice Address - Phone:407-593-2883
Practice Address - Fax:407-593-2884
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105478208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL148NTOtherBCBS OF FL
FL002307600Medicaid