Provider Demographics
NPI:1376723031
Name:SAHAI PEDIATRICS, P.A.
Entity Type:Organization
Organization Name:SAHAI PEDIATRICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HENREY
Authorized Official - Last Name:SAHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-677-0780
Mailing Address - Street 1:750 W GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5108
Mailing Address - Country:US
Mailing Address - Phone:386-677-0780
Mailing Address - Fax:386-677-0855
Practice Address - Street 1:750 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5108
Practice Address - Country:US
Practice Address - Phone:386-677-0780
Practice Address - Fax:386-677-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-10
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58322261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05816400Medicaid
FLF16932Medicare UPIN