Provider Demographics
NPI:1376756981
Name:JEELANI, SADAF (MD)
Entity Type:Individual
Prefix:
First Name:SADAF
Middle Name:
Last Name:JEELANI
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 1:4340 W NEWBERRY RD
Mailing Address - Street 2:#301
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2557
Mailing Address - Country:US
Mailing Address - Phone:352-372-9414
Mailing Address - Fax:352-271-5393
Practice Address - Street 1:4340 W NEWBERRY RD
Practice Address - Street 2:#301
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2557
Practice Address - Country:US
Practice Address - Phone:352-372-9414
Practice Address - Fax:352-271-5393
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26556207RE0101X
FLME100655207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000083600Medicaid
FL68572OtherBCBS OF FLORIDA
FL68572OtherBCBS OF FLORIDA