Provider Demographics
NPI:1346259678
Name:EFTEKHARI, SAIED (MD)
Entity Type:Individual
Prefix:
First Name:SAIED
Middle Name:
Last Name:EFTEKHARI
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 1:19111 COLLINS AVE APT 2605
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2384
Mailing Address - Country:US
Mailing Address - Phone:217-971-0451
Mailing Address - Fax:
Practice Address - Street 1:19111 COLLINS AVE APT 2605
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2384
Practice Address - Country:US
Practice Address - Phone:217-971-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME572462080N0001X
TXH86282080N0001X
IL2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH8628OtherTX STATE LICENSE
FLME57246OtherFL STATE LICENSE
IL194065OtherHEALTHLINK
IL0005832074OtherBC/BS