MEDICARE: SADI A ABUSRUR MD PLLC

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	ME33741	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1912095258	OTHER	FL	TYPE 1 NPI

General Provider Information

NPI Number	:	1518217561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SADI A ABUSRUR MD PLLC

Provider Business Mailing Address
First Line	:	2116 S ORANGE AVE
Second Line	:	SUITE B
City	:	ORLANDO
State	:	FL
Zip	:	32806-3037
Country	:	US
Telephone Number	:	407-704-8990
Fax Number	:	407-730-5936

Provider Business Practice Location Address
First Line	:	2116 S ORANGE AVE
Second Line	:	SUITE B
City	:	ORLANDO
State	:	FL
Zip	:	32806-3037
Country	:	US
Telephone Number	:	407-704-8990
Fax Number	:	407-730-5936

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. SADI A ABUSRUR
Credential	:	MD
Telephone Number	:	407-704-8990

Provider Enumeration Date	:	09/18/2012
Last Update Date	:	09/18/2012

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