1922437516 NPI number — SALMA HITAWALA MD PA

Table of content: (NPI 1922437516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922437516 NPI number — SALMA HITAWALA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALMA HITAWALA MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922437516
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1609
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDERMERE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34786-1609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-625-3635
Provider Business Mailing Address Fax Number:
352-988-6460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 CITRUS TOWER BLVD
Provider Second Line Business Practice Location Address:
STE 205
Provider Business Practice Location Address City Name:
CLERMONT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34711-2756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-404-7874
Provider Business Practice Location Address Fax Number:
352-988-6460
Provider Enumeration Date:
11/05/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HITAWALA
Authorized Official First Name:
SALMA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/OFFICER
Authorized Official Telephone Number:
352-404-7874

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com