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Individual

HOUTAN SAREH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16420 HEALTHPARK COMMONS DR, FORT MYERS, FL 33908-9621
(239) 985-1925
(239) 321-6044
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 985-1925
(239) 468-7929

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME95768
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276252800
FL
01
304134
AVMED
FL
01
57601
BCBS OF FL
FL
01
7944871
AETNA
FL
01
9338156
CIGNA
FL
01
P01319830
RR MEDICARE
FL
01
P100579
FRREDOM
FL
01
P954381
OPTIMUM
FL
Enumeration date
09/06/2006
Last updated
08/20/2024
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