Basic Information
| Provider Information | |||||||||
| NPI: | 1821209016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALAMA | ||||||||
| FirstName: | MOISES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4519 GEORGE RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336347329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134961075 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21097 NE 27TH CT | ||||||||
| Address2: | STE 335 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059334033 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2007 | ||||||||
| LastUpdateDate: | 07/14/2010 | ||||||||
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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 | ME102672 | FL | Y | Allopathic & Osteopathic Physicians | Plastic Surgery | 2082S0099X | ME102672 | FL | N | Allopathic & Osteopathic Physicians | Plastic Surgery | Plastic Surgery Within the Head and Neck | 2082S0105X | ME102672 | FL | N | Allopathic & Osteopathic Physicians | Plastic Surgery | Surgery of the Hand | 208600000X | ME102672 | FL | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0122X | ME102672 | FL | N | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery | 2086S0105X | ME102672 | FL | N | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
No ID Information.