Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | ME0057785 | FL |
NPI | 1295784551 |
---|---|
Provider Name | Dr. Mohamad Iqbal Saleh |
First Address | Spring Hill, FL 34611-5733 |
Second Address | Riverview, FL 33578-7419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2006 |
Last Update Date | 19/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064395500 | (05) | FL |
E61833 | (02) |