Provider Demographics
NPI:1619960689
Name:SULIMAN, OSAMA M (MD)
Entity Type:Individual
Prefix:DR
First Name:OSAMA
Middle Name:M
Last Name:SULIMAN
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 1:11950 COUNTY ROAD 101
Mailing Address - Street 2:STE 203
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-9334
Mailing Address - Country:US
Mailing Address - Phone:727-344-6000
Mailing Address - Fax:727-344-7732
Practice Address - Street 1:6255 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8431
Practice Address - Country:US
Practice Address - Phone:727-344-6000
Practice Address - Fax:727-344-7732
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45590208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD57523Medicare UPIN
FL62623Medicare ID - Type Unspecified