Provider Demographics
NPI:1356648737
Name:SALEH HEALTHCARE INSTITUTE OF FLORIDA (SHIFA)
Entity Type:Organization
Organization Name:SALEH HEALTHCARE INSTITUTE OF FLORIDA (SHIFA)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-684-5880
Mailing Address - Street 1:1771 S KINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6220
Mailing Address - Country:US
Mailing Address - Phone:813-684-5880
Mailing Address - Fax:
Practice Address - Street 1:1771 S KINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6220
Practice Address - Country:US
Practice Address - Phone:813-684-5880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-19
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57785204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE61833Medicare UPIN