Provider Demographics
NPI:1013086305
Name:AL-HALAWANI, MONTHER HAFEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MONTHER
Middle Name:HAFEZ
Last Name:AL-HALAWANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 CORNER DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5724
Mailing Address - Country:US
Mailing Address - Phone:813-643-4722
Mailing Address - Fax:813-651-3280
Practice Address - Street 1:502 CORNER DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5724
Practice Address - Country:US
Practice Address - Phone:813-643-4722
Practice Address - Fax:813-651-3280
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72768207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3300200OtherUNITED HEALTHCARE
FL0737733OtherAETNA
FL225514OtherAV-MED
FL2300240OtherGHI
FL14637OtherWELLCARE
FL2962501006OtherCIGNA
FL38043OtherBCBS FL
FL460001515OtherRAILROAD MEDICARE
FL593446898OtherTAX ID#
FL460001515OtherRAILROAD MEDICARE
FL225514OtherAV-MED
FL0737733OtherAETNA
FL593446898OtherTAX ID#