MEDICARE: SAMER ELHAKIM MD PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174895361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMER ELHAKIM MD PA

Provider Business Mailing Address
First Line	:	251 174TH ST
Second Line	:	APT. 1211
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-3300
Country	:	US
Telephone Number	:	305-200-6001
Fax Number	:	305-239-1562

Provider Business Practice Location Address
First Line	:	1318 SE 17TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-200-6001
Fax Number	:	954-239-1562

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SAMER ELHAKIM
Credential	:	MD
Telephone Number	:	954-200-6001

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	02/02/2012

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