Provider Demographics
NPI:1518250307
Name:SAKLA, SAMEH ADEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEH
Middle Name:ADEL
Last Name:SAKLA
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 1:1652 CANYON OAK WAY
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6853
Mailing Address - Country:US
Mailing Address - Phone:251-767-3203
Mailing Address - Fax:
Practice Address - Street 1:1652 CANYON OAK WAY
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6853
Practice Address - Country:US
Practice Address - Phone:251-767-3203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012765412085R0202X, 2085R0204X
CAA1546252085R0202X
KY574362085R0202X, 2085R0204X
LA3329502085R0202X, 2085R0204X
OH35.1465912085R0202X, 2085R0204X
AZ574862085R0202X
PAMD4795442085R0202X, 2085R0204X
FLME1495722085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology