Provider Demographics
NPI:1447786421
Name:SALIM, MOHAMMAD ALI HUMZA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:ALI HUMZA
Last Name:SALIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HUMZA
Other - Middle Name:
Other - Last Name:SALIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3130 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4306
Mailing Address - Country:US
Mailing Address - Phone:352-671-3130
Mailing Address - Fax:
Practice Address - Street 1:3130 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4306
Practice Address - Country:US
Practice Address - Phone:352-671-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4748062084P0800X
FLME1605592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME160559OtherSTATE LICENSE
15660449OtherCAQH
PAMD474806OtherSTATE LICENSE