Provider Demographics
NPI:1861375198
Name:SADR, KAMEL (RESPIRATORY CARE)
Entity type:Individual
Prefix:
First Name:KAMEL
Middle Name:
Last Name:SADR
Suffix:
Gender:M
Credentials:RESPIRATORY CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12450 GULLIVER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-4144
Mailing Address - Country:US
Mailing Address - Phone:352-232-1555
Mailing Address - Fax:
Practice Address - Street 1:2447 PACIFIC COAST HWY STE 200
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2714
Practice Address - Country:US
Practice Address - Phone:323-639-5436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1940119832278C0205X
WI5833-282278C0205X
VT122.01343992278C0205X
FLRT117182279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
No2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care