MEDICARE: SHERIF MAGDY AMIN

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	207Q00000X	Family Medicine Physician	ME158719	FL

General Provider Information

NPI Number	:	1629607239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERIF MAGDY AMIN

Provider Business Mailing Address
First Line	:	3128 E HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4528
Country	:	US
Telephone Number	:	813-579-1769
Fax Number	:	813-305-7907

Provider Business Practice Location Address
First Line	:	3128 E HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4528
Country	:	US
Telephone Number	:	813-579-1769
Fax Number	:	813-305-7907

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

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	06/13/2023

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