MEDICARE: DR. SHADY SAIKALI 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	208800000X	Urology Physician	36314	FL

General Provider Information

NPI Number	:	1356076087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHADY SAIKALI MD

Provider Business Mailing Address
First Line	:	2955 MALLORY CIR APT 5304
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34747-1841
Country	:	US
Telephone Number	:	863-558-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	380 CELEBRATION PL STE 401
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34747-4606
Country	:	US
Telephone Number	:	407-303-4673
Fax Number	:

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

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	07/18/2022

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