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General NPI Number Information
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NPI Number | 1003478264
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Entity Type | Individual
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Provider Name | SHERIF SAMAAN OPTICIAN
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Gender | Male
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 501 N ORLANDO AVE
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City | WINTER PARK
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State | FL
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Zip | 32789-7313
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Country | US
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Telephone | 407-755-2102
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Fax | 321-203-2122
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Provider Business Mailing Address
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Address Line | 501 N ORLANDO AVE STE 227
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City | WINTER PARK
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State | FL
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Zip | 32789-2947
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Country | US
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Telephone | 407-755-2102
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Fax | 321-203-2122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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