Provider Demographics
NPI:1093691792
Name:SOBOH, SALEH F
Entity type:Individual
Prefix:
First Name:SALEH
Middle Name:F
Last Name:SOBOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10956 N 56TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3008
Mailing Address - Country:US
Mailing Address - Phone:813-377-9837
Mailing Address - Fax:
Practice Address - Street 1:10956 N 56TH ST STE 202
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3008
Practice Address - Country:US
Practice Address - Phone:813-377-9837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL367500000X367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered