Basic Information
| Provider Information | |||||||||
| NPI: | 1902172828 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALEH | ||||||||
| FirstName: | OMAR | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2338 IMMOKALEE RD # 186 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341101445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393302933 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2338 IMMOKALEE ROAD | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393302933 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2012 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME137678 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 56170 | CT | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 17232 | NH | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 322450 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.