Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | ME119290 | FL |
Y | 207QA0401X | Family Doctor - Addiction Medicine | ME119290 | FL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME119290 | FL |
NPI | 1811200165 |
---|---|
Provider Name | Dr. Suzanne A Salhab |
First Address | Temple Terrace, FL 33617-1536 |
Second Address | Temple Terrace, FL 33617-1536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 29/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
651548 | (05) | FL |
ME119290 | ACTIVE LICENSE (01) | FL |
P01430305 | R&R MEDICARE (01) | FL |