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General NPI Number Information
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NPI Number | 1700011913
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Entity Type | Organization
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Legal Business Name | SARIDAKIS SURGICAL ASSOCIATES PA
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 5015 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6515
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Country | US
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Telephone | 954-962-3225
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Fax | 954-962-7199
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Provider Business Mailing Address
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Address Line | 5015 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6515
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Country | US
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Telephone | 954-962-3225
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Fax | 954-962-7199
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANGELEKE A SARIDAKIS
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Credential | M.D.
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Telephone | 954-962-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME83637
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License Number State | FL
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