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General NPI Number Information
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NPI Number | 1598794026
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Entity Type | Individual
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Provider Name | MOHAMED IBRAHIM ALI ELTOUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 5454 CENTRAL AVE SUITE A
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-6129
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Country | US
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Telephone | 727-347-5242
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Fax | 727-347-2402
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Provider Business Mailing Address
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Address Line | 5454 CENTRAL AVE SUITE A
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-6117
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Country | US
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Telephone | 727-347-5242
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Fax | 727-347-2402
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | ME100366
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME100366
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME100366
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License Number State | FL
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