Provider Demographics
NPI:1427093889
Name:SARAFOGLU, THEODORE (MD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:
Last Name:SARAFOGLU
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 1:6201 SW 118TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4823
Mailing Address - Country:US
Mailing Address - Phone:305-661-7548
Mailing Address - Fax:305-668-1601
Practice Address - Street 1:6201 SW 118TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-4823
Practice Address - Country:US
Practice Address - Phone:305-661-7548
Practice Address - Fax:305-668-1601
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16462207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91251Medicare UPIN