Provider Demographics
NPI:1114020534
Name:HERNANDEZ-CASSIS, SALEH (MD)
Entity Type:Individual
Prefix:
First Name:SALEH
Middle Name:
Last Name:HERNANDEZ-CASSIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-408-3562
Mailing Address - Fax:
Practice Address - Street 1:15516 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1554
Practice Address - Country:US
Practice Address - Phone:305-387-3300
Practice Address - Fax:305-383-9945
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-90666207R00000X, 207RG0300X
FLME90666208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272459600Medicaid
FLU-3289ZMedicare ID - Type Unspecified