Provider Demographics
NPI:1386625929
Name:SAHADEO, WOMESH C (MD)
Entity Type:Individual
Prefix:DR
First Name:WOMESH
Middle Name:C
Last Name:SAHADEO
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 1:1115 45TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2376
Mailing Address - Country:US
Mailing Address - Phone:561-863-4600
Mailing Address - Fax:561-863-4646
Practice Address - Street 1:1115 45TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2376
Practice Address - Country:US
Practice Address - Phone:561-863-4600
Practice Address - Fax:561-863-4646
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 00504722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049719301Medicaid
FL049719301Medicaid
FLE22508Medicare UPIN