Healthcare Provider Details

I. General information

NPI: 1346259678
Provider Name (Legal Business Name): SAIED EFTEKHARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19111 COLLINS AVE APT 2605
SUNNY ISLES BEACH FL
33160-2384
US

IV. Provider business mailing address

19111 COLLINS AVE APT 2605
SUNNY ISLES BEACH FL
33160-2384
US

V. Phone/Fax

Practice location:
  • Phone: 217-971-0451
  • Fax:
Mailing address:
  • Phone: 217-971-0451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME57246
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberH8628
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: