Provider Demographics
NPI:1922437516
Name:SALMA HITAWALA MD PA
Entity Type:Organization
Organization Name:SALMA HITAWALA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HITAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-404-7874
Mailing Address - Street 1:PO BOX 1609
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-1609
Mailing Address - Country:US
Mailing Address - Phone:407-625-3635
Mailing Address - Fax:352-988-6460
Practice Address - Street 1:255 CITRUS TOWER BLVD
Practice Address - Street 2:STE 205
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2756
Practice Address - Country:US
Practice Address - Phone:352-404-7874
Practice Address - Fax:352-988-6460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHP617AMedicare PIN