Healthcare Provider Details
I. General information
NPI: 1720861008
Provider Name (Legal Business Name): FAHIMY SAOUD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/18/2023
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13880 SHELL POINT PLZ STE 110
FORT MYERS FL
33908-3504
US
IV. Provider business mailing address
13880 SHELL POINT PLZ STE 200
FORT MYERS FL
33908-3504
US
V. Phone/Fax
- Phone: 239-454-2146
- Fax: 239-454-2111
- Phone: 239-454-2146
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME166057 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: