Provider Demographics
NPI:1255692711
Name:DYER, SAREH S (MD)
Entity Type:Individual
Prefix:
First Name:SAREH
Middle Name:S
Last Name:DYER
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 1:846 LAKE HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5222
Mailing Address - Country:US
Mailing Address - Phone:407-767-2477
Mailing Address - Fax:407-767-7644
Practice Address - Street 1:846 LAKE HOWELL RD
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5222
Practice Address - Country:US
Practice Address - Phone:407-767-2477
Practice Address - Fax:407-767-7644
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1222192080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine