Provider Demographics
NPI:1356076087
Name:SAIKALI, SHADY (MD)
Entity Type:Individual
Prefix:DR
First Name:SHADY
Middle Name:
Last Name:SAIKALI
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 1:2955 MALLORY CIR APT 5304
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-1841
Mailing Address - Country:US
Mailing Address - Phone:863-558-2548
Mailing Address - Fax:
Practice Address - Street 1:380 CELEBRATION PL STE 401
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-4606
Practice Address - Country:US
Practice Address - Phone:407-303-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36314208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology