1952396459 NPI number — EMERY M. SALOM MD

Table of content: MRS. ORLI SHALOUH I (NPI 1427810068)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952396459 NPI number — EMERY M. SALOM MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALOM
Provider First Name:
EMERY
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1952396459
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12741 MIRAMAR PKWY
Provider Second Line Business Mailing Address:
STE 302
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33027-2905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-602-9723
Provider Business Mailing Address Fax Number:
954-602-9724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7100 W 20TH AVE
Provider Second Line Business Practice Location Address:
SUITE 702
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33016-1897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-828-8688
Provider Business Practice Location Address Fax Number:
305-828-8655
Provider Enumeration Date:
09/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VX0201X , with the licence number:  ME77021 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000021064-W . This is a "HUMANA PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1952396459 . This is a "MD MEDICARE CHOICE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0296791 . This is a "GHI PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 50345 . This is a "NEIGHBORHOOD PROV. #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 270790000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7136647 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 326631 . This is a "WELLCARE PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3604 . This is a "TOTAL HLTH CH. PROV. #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8641070-001 . This is a "CIGNA HMO PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 969333 . This is a "USA MNGD. CR. PROV. #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: GS076660 . This is a "VISTA PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 295791 . This is a "AVMED THRU PARITY PROV. #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 52127 . This is a "BCBS OF FL. PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8641070-002 . This is a "CIGNA PPO PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 011650100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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