Healthcare Provider Details

I. General information

NPI: 1790314060
Provider Name (Legal Business Name): MOHAMMAD HELALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PL STE 604
HIALEAH FL
33012-3158
US

IV. Provider business mailing address

18255 NW 68TH AVE APT 329
HIALEAH FL
33015-3489
US

V. Phone/Fax

Practice location:
  • Phone: 678-512-9536
  • Fax:
Mailing address:
  • Phone: 678-512-9536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2020002029
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME182860
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN39303
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: