Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME72768 | FL |
NPI | 1013086305 |
---|---|
Provider Name | Dr. Monther Hafez Al-Halawani |
First Address | Brandon, FL 33511-5724 |
Second Address | Brandon, FL 33511-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 11/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0737733 | AETNA (01) | FL |
14637 | WELLCARE (01) | FL |
225514 | AV-MED (01) | FL |
2300240 | GHI (01) | FL |
2962501006 | CIGNA (01) | FL |
3300200 | UNITED HEALTHCARE (01) | FL |
38043 | BCBS FL (01) | FL |
460001515 | RAILROAD MEDICARE (01) | FL |
593446898 | TAX ID# (01) | FL |
F72380 | (02) | FL |