Provider Demographics
NPI:1487238036
Name:MOHAMED, SUMER ELSAYED (DO)
Entity type:Individual
Prefix:DR
First Name:SUMER
Middle Name:ELSAYED
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 TOSCANA DR APT 224
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3493
Mailing Address - Country:US
Mailing Address - Phone:732-749-0007
Mailing Address - Fax:
Practice Address - Street 1:1825 PONCE DE LEON BLVD STE 142
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4418
Practice Address - Country:US
Practice Address - Phone:305-213-7717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS20444208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine