Provider Demographics
NPI:1851553606
Name:AL-HAFNAWI, MOTAZ K (MD)
Entity type:Individual
Prefix:DR
First Name:MOTAZ
Middle Name:K
Last Name:AL-HAFNAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18669 TAMIAMI TRL
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-7388
Mailing Address - Country:US
Mailing Address - Phone:941-423-5040
Mailing Address - Fax:
Practice Address - Street 1:18669 TAMIAMI TRL
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-7388
Practice Address - Country:US
Practice Address - Phone:941-423-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0581207RG0100X, 207R00000X, 208M00000X
FLME104852207RG0100X, 208M00000X, 207RG0100X
NY249381207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400000346Medicare PIN