Provider Demographics
NPI:1942324082
Name:MOHAMAD IQBAL SALEH MD PA
Entity Type:Organization
Organization Name:MOHAMAD IQBAL SALEH MD PA
Other - Org Name:COMMUNITY NEUROLOGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-556-4080
Mailing Address - Street 1:PO BOX 5733
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611-5733
Mailing Address - Country:US
Mailing Address - Phone:352-556-4080
Mailing Address - Fax:352-556-4081
Practice Address - Street 1:10141 BIG BEND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7419
Practice Address - Country:US
Practice Address - Phone:352-556-4080
Practice Address - Fax:352-556-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
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