Healthcare Provider Details

I. General information

NPI: 1952787848
Provider Name (Legal Business Name): AHMED ALY ELGHAWY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

V. Phone/Fax

Practice location:
  • Phone: 56-743-3140
  • Fax: 305-674-2070
Mailing address:
  • Phone: 484-213-3185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS21502
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberOS21502
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberOS21502
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: