Provider Demographics
NPI:1578522413
Name:SALEM CHALLITA, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SALEM CHALLITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CAMINO REAL
Mailing Address - Street 2:URB GRAN VISTA I
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5004
Mailing Address - Country:US
Mailing Address - Phone:787-253-3328
Mailing Address - Fax:787-253-3328
Practice Address - Street 1:CAROLINA SHOPPING COURT, SUITE 201 A
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-767-8758
Practice Address - Fax:844-759-2966
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10552208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38109600Medicaid