Healthcare Provider Details

I. General information

NPI: 1396427902
Provider Name (Legal Business Name): ALAA SAAD ABUJAME
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SUN N LAKE BLVD
SEBRING FL
33872-1986
US

IV. Provider business mailing address

4200 SUN N LAKE BLVD
SEBRING FL
33872-1986
US

V. Phone/Fax

Practice location:
  • Phone: 863-314-4466
  • Fax:
Mailing address:
  • Phone: 863-314-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME181890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: