Provider Demographics
NPI:1770780603
Name:KENAWY, AYMEN AHMED (MD)
Entity type:Individual
Prefix:DR
First Name:AYMEN
Middle Name:AHMED
Last Name:KENAWY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3890 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4701
Mailing Address - Country:US
Mailing Address - Phone:850-215-6400
Mailing Address - Fax:850-215-4440
Practice Address - Street 1:3890 JENKS AVE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4701
Practice Address - Country:US
Practice Address - Phone:850-215-6400
Practice Address - Fax:850-215-4440
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN11579207R00000X
FLME 104930207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine