Provider Demographics
NPI:1194266544
Name:SALAMEKH, SAMER (MD)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:
Last Name:SALAMEKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7751 BELFORT PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6951
Mailing Address - Country:US
Mailing Address - Phone:904-363-7453
Mailing Address - Fax:904-538-3672
Practice Address - Street 1:2 SHIRCLIFF WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4753
Practice Address - Country:US
Practice Address - Phone:904-388-2619
Practice Address - Fax:904-388-0240
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-18
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1552862085R0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ00364363OtherRR MEDICARE
FL114699400Medicaid
FLUNKZBOtherFL BLUE
FLPJ136OtherMEDICARE