Provider Demographics
NPI:1215357215
Name:ZAHEDI, SANAM (MD)
Entity Type:Individual
Prefix:
First Name:SANAM
Middle Name:
Last Name:ZAHEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 SW 1ST AVE APT 503
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-4417
Mailing Address - Country:US
Mailing Address - Phone:954-463-5208
Mailing Address - Fax:954-463-5208
Practice Address - Street 1:407 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-3915
Practice Address - Country:US
Practice Address - Phone:954-463-5208
Practice Address - Fax:954-463-5288
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1546002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery