Provider Demographics
NPI:1245285238
Name:EL-YOUSEF, MOHAMMED KHALED (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:KHALED
Last Name:EL-YOUSEF
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 1:1555 S FORT HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2004
Mailing Address - Country:US
Mailing Address - Phone:727-446-2005
Mailing Address - Fax:727-441-2849
Practice Address - Street 1:1555 S FORT HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2004
Practice Address - Country:US
Practice Address - Phone:727-446-2005
Practice Address - Fax:727-441-2849
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00223232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD70622Medicare UPIN