Provider Demographics
NPI:1043464464
Name:SALIM HAMADE M.D., P.A.
Entity type:Organization
Organization Name:SALIM HAMADE M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-233-0111
Mailing Address - Street 1:900 CARILLON PKWY
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1121
Mailing Address - Country:US
Mailing Address - Phone:727-233-0111
Mailing Address - Fax:727-231-8100
Practice Address - Street 1:900 CARILLON PKWY
Practice Address - Street 2:SUITE 112
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1121
Practice Address - Country:US
Practice Address - Phone:727-233-0111
Practice Address - Fax:727-231-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071332207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008305300Medicaid
FL32180YOtherMEDICARE INDIVIDUAL PTAN
FL008305300Medicaid