Provider Demographics
NPI:1669101820
Name:ALDAHER, SAMER (OD)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:
Last Name:ALDAHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:SAMER
Other - Middle Name:S
Other - Last Name:ALDAHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:845-534-5800
Mailing Address - Fax:
Practice Address - Street 1:20449 STATE ROAD 7 STE A4
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6776
Practice Address - Country:US
Practice Address - Phone:561-487-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-05
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009544152W00000X
FLOPC6427152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty