Provider Demographics
NPI:1003478264
Name:SAMAAN, SHERIF (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:
Last Name:SAMAAN
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N ORLANDO AVE STE 227
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2947
Mailing Address - Country:US
Mailing Address - Phone:407-755-2102
Mailing Address - Fax:321-203-2122
Practice Address - Street 1:501 N ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7313
Practice Address - Country:US
Practice Address - Phone:407-755-2102
Practice Address - Fax:321-203-2122
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician