Provider Demographics
NPI:1760486237
Name:SAFDAR, SYED ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ALI
Last Name:SAFDAR
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:PO BOX 48589
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-0122
Mailing Address - Country:US
Mailing Address - Phone:813-715-4446
Mailing Address - Fax:813-780-7786
Practice Address - Street 1:37900 DAUGHTERY RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541
Practice Address - Country:US
Practice Address - Phone:813-715-4446
Practice Address - Fax:813-780-7786
Is Sole Proprietor?:No
Enumeration Date:2005-06-11
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250174100Medicaid
110232732OtherRAIL ROAD MEDICARE
FLG36627Medicare UPIN
FL31605XMedicare ID - Type Unspecified