Healthcare Provider Details

I. General information

NPI: 1811161680
Provider Name (Legal Business Name): MAZEN ALBELDAWI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 GOODLETTE-FRANK RD N FL 2
NAPLES FL
34102-5644
US

IV. Provider business mailing address

1285 CREEKSIDE BLVD E UNIT 102
NAPLES FL
34109-0595
US

V. Phone/Fax

Practice location:
  • Phone: 239-291-7005
  • Fax: 239-624-8071
Mailing address:
  • Phone: 239-624-8070
  • Fax: 239-624-8071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME119815
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: