MEDICARE: DR. MOHAMED IBRAHIM ALI ELTOUM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician	ME100366	FL
2	207RP1001X	Pulmonary Disease Physician	ME100366	FL
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME100366	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BJ846	OTHER	FL	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	263769693	OTHER	FL	GROUP TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598794026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMED IBRAHIM ALI ELTOUM M.D.

Provider Business Mailing Address
First Line	:	5454 CENTRAL AVE
Second Line	:	SUITE A
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33707-6117
Country	:	US
Telephone Number	:	727-347-5242
Fax Number	:	727-347-2402

Provider Business Practice Location Address
First Line	:	5454 CENTRAL AVE
Second Line	:	SUITE A
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33707-6129
Country	:	US
Telephone Number	:	727-347-5242
Fax Number	:	727-347-2402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	09/15/2021

Similar Medicare Providers

1396981635 — PASADENA CENTER FOR ASTHMA & LUNG DISORDERS LLC
Practice Location Address:

5454 CENTRAL AVE STE A
SAINT PETERSBURG, FL
33707-6129

Practice Phone: 727-347-5242
Practice Fax: 727-347-2402

1770042335 — NEW POWER MEDICINE INC.
Practice Location Address:

5454 CENTRAL AVE STE C
SAINT PETERSBURG, FL
33707-6129

Practice Phone: 727-498-8608
Practice Fax:

1053184143 — DEBORAH R JOHNSON-EADY APRN
Practice Location Address:

5454 CENTRAL AVE STE A
SAINT PETERSBURG, FL
33707-6129

Practice Phone: 727-347-5242
Practice Fax: 727-347-2402

1861337990 — AFFIRM HOME HEALTHCARE SERVICES LLC
Practice Location Address:

2310 OUTLOOK DR
SAINT LOUIS, MO
63136-6129

Practice Phone: 314-281-3737
Practice Fax:

1447650650 — MUM-FORD INC
Practice Location Address:

6129 SAINT CLAIR AVE
CLEVELAND, OH
44103-1627

Practice Phone: 216-541-3937
Practice Fax: 216-391-3930

1841647641 — CANDACE MACATANGAY NP
Practice Location Address:

6129 SAINT CLAIR AVE
NORTH HOLLYWOOD, CA
91606-4631

Practice Phone: 323-377-1337
Practice Fax:

Directions to “ DR. MOHAMED IBRAHIM ALI ELTOUM M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.