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1114020047

NPI Code Detail

MEDICARE: SAMEH IBRAHIM MD

MEDICARE: SAMEH IBRAHIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	ME96555	FL
2	207L00000X	Anesthesiology Physician	39215	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114020047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMEH IBRAHIM MD

Provider Business Mailing Address
First Line	:	3601 W COMMERCIAL BLVD STE 5
Second Line	:	ANESCO NORTH BROWARD LLC
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3392
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

Provider Business Practice Location Address
First Line	:	3601 W COMMERCIAL BLVD STE 5
Second Line	:	ANESCO NORTH BROWARD LLC
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3392
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	03/30/2026

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Directions to “ SAMEH IBRAHIM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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