Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | ME30408 | FL |
NPI | 1043215577 |
---|---|
Provider Name | Rahim Salari |
First Address | Lakeland, FL 33813-4654 |
Second Address | Lakeland, FL 33813-4654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 13/05/2020 |