Healthcare Provider Details

I. General information

NPI: 1588575971
Provider Name (Legal Business Name): HOSSAM METWALY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10925 STATE ROAD 54
NEW PORT RICHEY FL
34655-2277
US

IV. Provider business mailing address

10925 STATE ROAD 54
NEW PORT RICHEY FL
34655-2277
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-9030
  • Fax:
Mailing address:
  • Phone: 727-372-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71553
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: