Basic Information
Provider Information
NPI: 1649338492
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARAI
FirstName: DIDAR
MiddleName: SINGH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SARAI
OtherFirstName: DIDAR
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 1545 9TH ST SW
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329624312
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7722133157
Practice Location
Address1: 787 37TH ST STE 140
Address2:  
City: VERO BEACH
State: FL
PostalCode: 32960
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7722133157
Other Information
ProviderEnumerationDate: 12/05/2006
LastUpdateDate: 04/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME126075FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
ME12607501FLSTATE LICENSEOTHER


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