Provider Demographics
NPI:1366670598
Name:HALAIBEH, SULEIMAN (MBBS)
Entity Type:Individual
Prefix:
First Name:SULEIMAN
Middle Name:
Last Name:HALAIBEH
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SA. INC. MEDICAL SERVICES, AVE. LAURO PINERO 195 CEIB
Mailing Address - Street 2:
Mailing Address - City:CEIBA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00735
Mailing Address - Country:UM
Mailing Address - Phone:787-885-4141
Mailing Address - Fax:
Practice Address - Street 1:105 FRANKLIN ST UNIT 7
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3149
Practice Address - Country:US
Practice Address - Phone:401-315-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR18410208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program