Healthcare Provider Details

I. General information

NPI: 1528293594
Provider Name (Legal Business Name): MOHAMED EL-HUSSEIN SHARABY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1066 SEAGRAPE DR
RUSKIN FL
33570-3048
US

IV. Provider business mailing address

100 MAIN ST N UNIT 1510
SAINT PETERSBURG FL
33716-1363
US

V. Phone/Fax

Practice location:
  • Phone: 954-806-2420
  • Fax:
Mailing address:
  • Phone: 954-806-2420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME131570
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101254707
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA123591
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberME131570
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: