Provider Demographics
NPI:1598279671
Name:HAFEEZ, SADAF (MD)
Entity Type:Individual
Prefix:
First Name:SADAF
Middle Name:
Last Name:HAFEEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:213 NW SAINT JAMES DR STE 3
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1291
Practice Address - Country:US
Practice Address - Phone:772-446-4640
Practice Address - Fax:772-446-4922
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME144027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108871800Medicaid