Provider Demographics
NPI:1235640772
Name:SALUS NEUROMUSCULAR INSTITUTE, INC.
Entity Type:Organization
Organization Name:SALUS NEUROMUSCULAR INSTITUTE, INC.
Other - Org Name:SALUS NEUROMUSCULAR INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NABEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DO, MBA, MPH
Authorized Official - Phone:305-280-0505
Mailing Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 705
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4725
Mailing Address - Country:US
Mailing Address - Phone:305-280-0505
Mailing Address - Fax:305-280-0599
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 705
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4725
Practice Address - Country:US
Practice Address - Phone:305-280-0505
Practice Address - Fax:305-280-0599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10968204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty