1689025215 NPI number — ABBY SAEDI MD LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689025215 NPI number — ABBY SAEDI MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABBY SAEDI MD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689025215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
243 NOB HILL CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONGWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32779-4430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-277-6441
Provider Business Mailing Address Fax Number:
407-884-5337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
661 E ALTAMONTE DR
Provider Second Line Business Practice Location Address:
SUITE 331
Provider Business Practice Location Address City Name:
ALTAMONTE SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32701-5105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-230-8139
Provider Business Practice Location Address Fax Number:
407-884-5337
Provider Enumeration Date:
06/24/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SAEDI
Authorized Official First Name:
ABBASEH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
407-230-8139

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME110125 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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