Provider Demographics
NPI:1710406228
Name:SAIDI, SASHA (PA-C)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:SAIDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 PEPPER TREE LN APT 4208
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-7626
Mailing Address - Country:US
Mailing Address - Phone:1423-762-4787
Mailing Address - Fax:
Practice Address - Street 1:16810 SOUTH HIGHWAY 441
Practice Address - Street 2:SUITE 502
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491
Practice Address - Country:US
Practice Address - Phone:844-682-8261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9110190208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine