Provider Demographics
NPI:1528240298
Name:NADIA M SADEK MD PA
Entity type:Organization
Organization Name:NADIA M SADEK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SADEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-297-3838
Mailing Address - Street 1:1151 BLACKWOOD AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4523
Mailing Address - Country:US
Mailing Address - Phone:407-297-3838
Mailing Address - Fax:407-447-6046
Practice Address - Street 1:1151 BLACKWOOD AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4523
Practice Address - Country:US
Practice Address - Phone:407-297-3838
Practice Address - Fax:407-447-6046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063524300Medicaid
FLK0511Medicare PIN