Healthcare Provider Details

I. General information

NPI: 1265307078
Provider Name (Legal Business Name): MOHAMMED ELOMARI OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27835 WESLEY CHAPEL BLVD STE 110
WESLEY CHAPEL FL
33544-4201
US

IV. Provider business mailing address

2240 FAIRCHILD ST
PENSACOLA FL
32504-6519
US

V. Phone/Fax

Practice location:
  • Phone: 813-907-9122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: