Provider Demographics
NPI:1699830794
Name:SALEEM HAQ, M.D., P.A.
Entity Type:Organization
Organization Name:SALEEM HAQ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:ABDUL
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-968-2955
Mailing Address - Street 1:4845 COCONUT CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3944
Mailing Address - Country:US
Mailing Address - Phone:954-968-2955
Mailing Address - Fax:954-968-8559
Practice Address - Street 1:4845 COCONUT CREEK PKWY
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063-3944
Practice Address - Country:US
Practice Address - Phone:954-968-2955
Practice Address - Fax:954-968-8559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBH1149283OtherCONTROL SUBSTANCE
FLME0046150OtherLICENSE NUMBER
FL02355Medicare PIN
FLBH1149283OtherCONTROL SUBSTANCE