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General NPI Number Information
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NPI Number | 1831823772
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Entity Type | Individual
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Provider Name | ALAA FAWZY
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Gender | Male
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 5236 LEGENDARY LOOP APT 212
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-8659
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Country | US
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Telephone | 614-369-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 5236 LEGENDARY LOOP APT 212
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-8659
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Country | US
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Telephone | 614-369-7700
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 38673
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN29851
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 38673
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License Number State | TX
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