Organization
MONTHER AL-HALAWANI, MD, PA
Active
Other names
CENTER FOR DIABETES AND METABOLIC DISORDERS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRINELLA SUE JOHNSTON (OFFICE MANAGER)
(813) 643-4722
Entity
Organization
Contact information
Practice address
502 CORNER DR, BRANDON, FL 33511-5724
(813) 643-4722
(813) 651-3280
Mailing address
502 CORNER DR, BRANDON, FL 33511-5724
(813) 643-4722
(813) 651-3280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME72768
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38043
BCBS PROVIDER ID
—
01
—
ME0072768
FL LIC. NUMBER
FL
Enumeration date
09/23/2010
Last updated
08/11/2020
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