Provider Demographics
NPI:1356392294
Name:SALEEBY, ELI RICHARD (MD)
Entity type:Individual
Prefix:
First Name:ELI
Middle Name:RICHARD
Last Name:SALEEBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3000 N UNIVERSITY DR
Mailing Address - Street 2:STE K
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5055
Mailing Address - Country:US
Mailing Address - Phone:954-752-7552
Mailing Address - Fax:954-752-4737
Practice Address - Street 1:1460 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6040
Practice Address - Country:US
Practice Address - Phone:954-752-7552
Practice Address - Fax:954-752-4737
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME48632207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2200180OtherGHI
FL010142OtherAVMED
FL94499OtherBCBS
FL525765OtherUNITED
FL04069037OtherAETNA
FL070003807OtherMEDICARE RAILROAD
FL010142OtherAVMED
FL94499OtherBCBS