Provider Demographics
NPI:1194546564
Name:SARAH SIDDIQUI DO LLC
Entity type:Organization
Organization Name:SARAH SIDDIQUI DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:FATIMA
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:321-300-2918
Mailing Address - Street 1:9161 NARCOOSSEE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-5764
Mailing Address - Country:US
Mailing Address - Phone:321-300-2918
Mailing Address - Fax:407-798-8072
Practice Address - Street 1:9161 NARCOOSSEE RD STE 209
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-5764
Practice Address - Country:US
Practice Address - Phone:321-300-2918
Practice Address - Fax:407-798-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty