Healthcare Provider Details

I. General information

NPI: 1396322731
Provider Name (Legal Business Name): CAYLA SEDANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAYLA SUTHUMPHONG MD

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE # C-301
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1611 NW 12TH AVE # C-301
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6970
  • Fax:
Mailing address:
  • Phone: 305-585-7037
  • Fax: 305-545-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME172657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: