Provider Demographics
NPI:1295784551
Name:SALEH, MOHAMAD IQBAL (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:IQBAL
Last Name:SALEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
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 1:13250 N 56TH ST STE 102
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-1165
Practice Address - Country:US
Practice Address - Phone:352-556-4080
Practice Address - Fax:352-556-4081
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0057785204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064395500Medicaid
FL10770WMedicare PIN
FL064395500Medicaid