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NPI Code Detail

MEDICARE: MENA SHENOUDA

MEDICARE: MENA SHENOUDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN23464FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316430796
Entity Type Code : Individual
Provider Name (Legal Business Name) : MENA SHENOUDA
Provider Business Mailing Address
First Line : 9656 AVELLINO AVE UNIT 7102
Second Line :
City : ORLANDO
State : FL
Zip : 32819-8861
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2907 VINELAND RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-5505
Country : US
Telephone Number : 407-396-1288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2018
Last Update Date : 06/11/2018

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Directions to “ MENA SHENOUDA ” Practice Location

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