Provider Demographics
NPI:1366677262
Name:SALAHUDDIN, ASMA NAJEEB (MD)
Entity Type:Individual
Prefix:DR
First Name:ASMA
Middle Name:NAJEEB
Last Name:SALAHUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 PRUDENTIAL DR
Mailing Address - Street 2:SUITE 1130
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8329
Mailing Address - Country:US
Mailing Address - Phone:904-633-4199
Mailing Address - Fax:904-633-4188
Practice Address - Street 1:841 PRUDENTIAL DR
Practice Address - Street 2:SUITE 1130
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8329
Practice Address - Country:US
Practice Address - Phone:904-633-4199
Practice Address - Fax:904-633-4188
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN13470208000000X
FLME113495208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14L1TOtherBCBSFL
FL005949200Medicaid
GA003125691AMedicaid
FL005949200Medicaid