Provider Demographics
NPI:1619097169
Name:SEYLABI, OMID M (MD)
Entity Type:Individual
Prefix:DR
First Name:OMID
Middle Name:M
Last Name:SEYLABI
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 1:241 LAFAYETTE RD
Mailing Address - Street 2:APT 341
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-2931
Mailing Address - Country:US
Mailing Address - Phone:315-416-3753
Mailing Address - Fax:
Practice Address - Street 1:2100 NE 36TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-7574
Practice Address - Country:US
Practice Address - Phone:954-781-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98075207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology