MEDICARE: EL- SALAWY MEDICAL PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
2	207R00000X	Internal Medicine Physician
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1437979622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL- SALAWY MEDICAL PA

Provider Business Mailing Address
First Line	:	150 SOUTHPARK BLVD STE 102
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5122
Country	:	US
Telephone Number	:	352-514-5211
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 SOUTHPARK BLVD STE 102
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5122
Country	:	US
Telephone Number	:	904-342-5002
Fax Number	:	904-342-5550

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	SCOTT MITCHELL HALL
Credential	:
Telephone Number	:	386-385-3857

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	05/25/2026

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Directions to “EL- SALAWY MEDICAL PA ” Practice Location

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