Provider Demographics
NPI:1689939910
Name:OMAR, SABRY AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:SABRY
Middle Name:AHMAD
Last Name:OMAR
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 1:901 VENETIA BAY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-8046
Mailing Address - Country:US
Mailing Address - Phone:941-497-5511
Mailing Address - Fax:941-492-2221
Practice Address - Street 1:901 VENETIA BAY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-8046
Practice Address - Country:US
Practice Address - Phone:941-497-5511
Practice Address - Fax:941-492-2221
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127844207RC0000X, 207RI0011X
390200000X
NY297495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program