Provider Demographics
NPI:1437979622
Name:EL- SALAWY MEDICAL PA
Entity type:Organization
Organization Name:EL- SALAWY MEDICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:EL-SALAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-514-5211
Mailing Address - Street 1:351 TOWN PLAZA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-5179
Mailing Address - Country:US
Mailing Address - Phone:352-514-5211
Mailing Address - Fax:
Practice Address - Street 1:150 SOUTHPARK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5122
Practice Address - Country:US
Practice Address - Phone:904-342-5002
Practice Address - Fax:904-342-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty