Provider Demographics
NPI:1295781912
Name:SABET-PAYMAN, DARYOUSH (MD)
Entity type:Individual
Prefix:
First Name:DARYOUSH
Middle Name:
Last Name:SABET-PAYMAN
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 1:809 COUNTY ROAD 466, SUITE 302
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159
Mailing Address - Country:US
Mailing Address - Phone:352-391-1750
Mailing Address - Fax:352-391-1752
Practice Address - Street 1:809 CR 466 STE 302
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3215
Practice Address - Country:US
Practice Address - Phone:352-391-1750
Practice Address - Fax:352-391-1752
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89963207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00195267OtherRAILROAD MEDICARE
FL43127OtherBLUE CROSS BLUE SHIELD FL
FL269605300Medicaid
FLP00195267OtherRAILROAD MEDICARE
I05753Medicare UPIN