Provider Demographics
NPI:1780831628
Name:ABOU EL FADL, MOHAMED HASSAN ANIS (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:HASSAN ANIS
Last Name:ABOU EL FADL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8600 SW 92ND ST STE 204A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7397
Mailing Address - Country:US
Mailing Address - Phone:305-216-7312
Mailing Address - Fax:305-500-2137
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:305-661-9404
Practice Address - Fax:305-661-1510
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME125755207RC0200X, 2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical CareGroup - Single Specialty