Healthcare Provider Details

I. General information

NPI: 1245285238
Provider Name (Legal Business Name): MOHAMMED KHALED EL-YOUSEF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 S FORT HARRISON AVE
CLEARWATER FL
33756-2004
US

IV. Provider business mailing address

1555 S FORT HARRISON AVE
CLEARWATER FL
33756-2004
US

V. Phone/Fax

Practice location:
  • Phone: 727-446-2005
  • Fax: 727-441-2849
Mailing address:
  • Phone: 727-446-2005
  • Fax: 727-441-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME0022323
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: