Provider Demographics
NPI:1174895361
Name:SAMER ELHAKIM MD PA
Entity type:Organization
Organization Name:SAMER ELHAKIM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:ELHAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-200-6001
Mailing Address - Street 1:251 174TH ST
Mailing Address - Street 2:APT. 1211
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3300
Mailing Address - Country:US
Mailing Address - Phone:305-200-6001
Mailing Address - Fax:305-239-1562
Practice Address - Street 1:1318 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1708
Practice Address - Country:US
Practice Address - Phone:954-200-6001
Practice Address - Fax:954-239-1562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty