Healthcare Provider Details
I. General information
NPI: 1144640855
Provider Name (Legal Business Name): EIHAB AKARY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/21/2014
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1541 FLORIDA AVE STE 100
MODESTO CA
95350-4438
US
IV. Provider business mailing address
2160 COLONIAL BLVD
FORT MYERS FL
33907-1410
US
V. Phone/Fax
- Phone: 209-577-3388
- Fax: 209-338-0024
- Phone: 239-931-7342
- Fax: 239-931-7385
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | ME139247 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: