Provider Demographics
NPI:1023302023
Name:SAEDI, ABBASEH (MD)
Entity type:Individual
Prefix:
First Name:ABBASEH
Middle Name:
Last Name:SAEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 NOB HILL CIR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4430
Mailing Address - Country:US
Mailing Address - Phone:407-844-8696
Mailing Address - Fax:407-884-5337
Practice Address - Street 1:1150 E SHERMAN BLVD STE 1175
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1885
Practice Address - Country:US
Practice Address - Phone:231-672-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110125207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010532900Medicaid
FL010532900Medicaid