Healthcare Provider Details

I. General information

NPI: 1578104527
Provider Name (Legal Business Name): M.K. EL-YOUSEF, M.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 S. FT HARRISON AVE
CLEARWATER FL
33756
US

IV. Provider business mailing address

1555 S. FT HARRISON AVE
CLEARWATER FL
33756
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 Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD KHALED EL-YOUSEF
Title or Position: OWNER
Credential: MD
Phone: 727-446-2005