Provider Demographics
NPI:1013530195
Name:GOZUSULU, SALMA (ARNP, FNP, NP)
Entity Type:Individual
Prefix:DR
First Name:SALMA
Middle Name:
Last Name:GOZUSULU
Suffix:
Gender:F
Credentials:ARNP, FNP, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 332
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-0332
Mailing Address - Country:US
Mailing Address - Phone:561-955-0739
Mailing Address - Fax:
Practice Address - Street 1:208 BRAZILIAN AVE
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4621
Practice Address - Country:US
Practice Address - Phone:561-955-0739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9999991207Q00000X
FL9999999207QA0505X
FL363LP2300X363LP2300X
FL2083C0008X2083C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care