Provider Demographics
NPI:1831352210
Name:AZEEM M SACHEDINA MD PA
Entity type:Organization
Organization Name:AZEEM M SACHEDINA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZEEM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SACHEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:954-722-4950
Mailing Address - Street 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:#310
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2977
Mailing Address - Country:US
Mailing Address - Phone:954-722-4950
Mailing Address - Fax:954-722-5008
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:#310
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-722-4950
Practice Address - Fax:954-722-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47063208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63274Medicare UPIN