Provider Demographics
NPI:1801040829
Name:SIPRA, SAJID WAZIR (MD)
Entity type:Individual
Prefix:
First Name:SAJID
Middle Name:WAZIR
Last Name:SIPRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 GIBRALTER DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1049 W ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3482
Practice Address - Country:US
Practice Address - Phone:407-884-2952
Practice Address - Fax:407-884-9352
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 103428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCS831ZOtherMEDICARE PTAN
FL000989900Medicaid