Provider Demographics
NPI:1700027299
Name:SALAMI, SULE STEVE (MD)
Entity Type:Individual
Prefix:DR
First Name:SULE
Middle Name:STEVE
Last Name:SALAMI
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 1:1691 MAYO DR
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4301
Mailing Address - Country:US
Mailing Address - Phone:352-253-0003
Mailing Address - Fax:352-253-0016
Practice Address - Street 1:1691 MAYO DR
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4301
Practice Address - Country:US
Practice Address - Phone:352-253-0003
Practice Address - Fax:352-253-0016
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHV129ZOtherMEDICARE PTAN