Provider Demographics
NPI:1821086703
Name:MAGHIDMAN, SAMUEL (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:MAGHIDMAN
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 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 920
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-397-8646
Mailing Address - Fax:888-275-5165
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 920
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-397-8646
Practice Address - Fax:888-275-5165
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93004207R00000X, 208M00000X
MO2011030110208M00000X
IN01071925A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I35561Medicare UPIN
FLU5010YMedicare PIN
FLU5010Medicare ID - Type Unspecified