Basic Information
| Provider Information | |||||||||
| NPI: | 1619960689 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SULIMAN | ||||||||
| FirstName: | OSAMA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11950 COUNTY ROAD 101 | ||||||||
| Address2: | STE 203 | ||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321629334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273446000 | ||||||||
| FaxNumber: | 7273447732 | ||||||||
| Practice Location | |||||||||
| Address1: | 6255 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337108431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273446000 | ||||||||
| FaxNumber: | 7273447732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2005 | ||||||||
| LastUpdateDate: | 06/29/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | ME45590 | FL | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.