Provider Demographics
NPI:1578440285
Name:MOMEN, SADID MOHAMMED
Entity type:Individual
Prefix:
First Name:SADID
Middle Name:MOHAMMED
Last Name:MOMEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 SW 35TH PL APT B-306
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9378
Mailing Address - Country:US
Mailing Address - Phone:561-927-6364
Mailing Address - Fax:
Practice Address - Street 1:3000 SW 35TH PL APT B-306
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9378
Practice Address - Country:US
Practice Address - Phone:561-927-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041624363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health