Individual provider Active NPI

Saeedeh Sharifzadehfomani

  • Nurse Practitioner
  • Winter Springs, FL
National Provider Identifier
1245915404
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG06230029 Issued in FL
Practice address
977 English Town LN Apt 203
Winter Springs, FL 32708-4669
Phone
(407) 779-4166
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG06230029 FL Primary

Addresses

Primary practice location

977 English Town LN Apt 203
Winter Springs, FL 32708-4669

Mailing address

977 English Town LN Apt 203
Winter Springs, FL 32708-4669
Phone (407) 779-4166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AG06230029FLMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1245915404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 ENGLISH TOWN LN APT 203",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327084669",
            "telephone_number": "407-779-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 ENGLISH TOWN LN APT 203",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327084669",
            "telephone_number": "407-779-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFZADEHFOMANI",
        "first_name": "SAEEDEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "AG06230029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.