Provider Demographics
NPI:1780812594
Name:ALDABBAGH, SIDIQ NAZAR (MD)
Entity type:Individual
Prefix:DR
First Name:SIDIQ
Middle Name:NAZAR
Last Name:ALDABBAGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7377
Mailing Address - Country:US
Mailing Address - Phone:786-360-4334
Mailing Address - Fax:786-360-4578
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-4960
Practice Address - Fax:305-585-7651
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301093891207V00000X
FL116310207V00000X
FLME116310207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology