MEDICARE: MENA TAWADROUS 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
1	207R00000X	Internal Medicine Physician	MTL004112	DC
2	207R00000X	Internal Medicine Physician	ME151758	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891226155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MENA TAWADROUS MD

Provider Business Mailing Address
First Line	:	1900 DON WICKHAM DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1979
Country	:	US
Telephone Number	:	352-536-8840
Fax Number	:	352-536-8841

Provider Business Practice Location Address
First Line	:	1900 DON WICKHAM DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1979
Country	:	US
Telephone Number	:	352-536-8840
Fax Number	:	352-536-8841

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

Provider Enumeration Date	:	03/27/2017
Last Update Date	:	04/16/2026

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Directions to “ MENA TAWADROUS MD” Practice Location

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