Provider Demographics
NPI:1730469362
Name:NAHED S. SOBHY M.D. P.A.
Entity Type:Organization
Organization Name:NAHED S. SOBHY M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHED
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOBHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-758-2944
Mailing Address - Street 1:305 E DUVAL ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-4093
Mailing Address - Country:US
Mailing Address - Phone:386-758-2944
Mailing Address - Fax:386-758-9800
Practice Address - Street 1:305 E DUVAL ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4093
Practice Address - Country:US
Practice Address - Phone:386-758-2944
Practice Address - Fax:386-758-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54812261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08495AMedicare PIN