Provider Demographics
NPI:1871864561
Name:SAFI, SEIED ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SEIED
Middle Name:ALI
Last Name:SAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9770 OLD BAYMEADOWS RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7909
Mailing Address - Country:US
Mailing Address - Phone:904-564-2700
Mailing Address - Fax:904-564-2800
Practice Address - Street 1:9770 OLD BAYMEADOWS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7909
Practice Address - Country:US
Practice Address - Phone:904-564-2700
Practice Address - Fax:904-564-2800
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME54100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL191457OtherWELLCARE/HEALTHEASE
FL08314OtherBLUE CROSS BLUE SHIELD
FL061396700Medicaid
FL209183OtherAVMED
FL593442982OtherAETNA
FL593442982OtherCIGNA