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NPI Code Detail

MEDICARE: KEROLLOS GEORGE IBRAHIM MD

MEDICARE: KEROLLOS GEORGE IBRAHIM MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramTRN45303FL

General Provider Information

NPI Number : 1821928433
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEROLLOS GEORGE IBRAHIM MD
Provider Business Mailing Address
First Line : 2501 N ORANGE AVE STE 235
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4659
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N ORANGE AVE STE 235
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4659
Country : US
Telephone Number : 844-407-4070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2026
Last Update Date : 05/23/2026

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Directions to “ KEROLLOS GEORGE IBRAHIM MD” Practice Location

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