Provider Demographics
NPI:1801086335
Name:LANALEE ARABA SAM MD PA
Entity type:Organization
Organization Name:LANALEE ARABA SAM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LANALEE
Authorized Official - Middle Name:ARABA
Authorized Official - Last Name:SAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:954-776-4877
Mailing Address - Street 1:2466 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4011
Mailing Address - Country:US
Mailing Address - Phone:954-776-4877
Mailing Address - Fax:954-229-9043
Practice Address - Street 1:2466 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4011
Practice Address - Country:US
Practice Address - Phone:954-776-4877
Practice Address - Fax:954-229-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266303100Medicaid
FL266303100Medicaid
FLK7065Medicare PIN