Healthcare Provider Details

I. General information

NPI: 1295268258
Provider Name (Legal Business Name): OMEED SIZAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 NE 1ST AVE APT 3308
MIAMI FL
33132-1829
US

IV. Provider business mailing address

698 NE 1ST AVE APT 3308
MIAMI FL
33132-1829
US

V. Phone/Fax

Practice location:
  • Phone: 505-322-3344
  • Fax:
Mailing address:
  • Phone: 505-322-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS16380
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO-55579
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101026558
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number350444
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number36672
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: