Provider Demographics
NPI:1396720710
Name:ELHAKIM, SAMER (MD)
Entity type:Individual
Prefix:DR
First Name:SAMER
Middle Name:
Last Name:ELHAKIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18260 NE 19TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1632
Mailing Address - Country:US
Mailing Address - Phone:305-956-9062
Mailing Address - Fax:
Practice Address - Street 1:459 W LINE ST STE C
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-3333
Practice Address - Country:US
Practice Address - Phone:760-784-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79405207Q00000X
CAA64024207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG65427Medicare UPIN