Healthcare Provider Details

I. General information

NPI: 1780831628
Provider Name (Legal Business Name): MOHAMED HASSAN ABOU EL FADL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MOHAMED ABOU EL FADL M.D.

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8600 SW 92ND ST STE 204A
MIAMI FL
33156-7397
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-9404
  • Fax: 305-661-1510
Mailing address:
  • Phone: 305-216-7312
  • Fax: 305-500-2137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME125755
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberME125755
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: