Healthcare Provider Details

I. General information

NPI: 1417917329
Provider Name (Legal Business Name): RONI I SEHAYIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1983 P G A BLVD SUITE 105
NORTH PALM BEACH FL
33408-3001
US

IV. Provider business mailing address

1983 P G A BLVD SUITE 105
NORTH PALM BEACH FL
33408-3001
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-3327
  • Fax: 561-627-3388
Mailing address:
  • Phone: 561-627-3327
  • Fax: 561-627-3388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME0039093
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: