Provider Demographics
NPI:1427096775
Name:SALEM, MUHAMMAD HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:HASSAN
Last Name:SALEM
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:PO BOX 1507
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-1507
Mailing Address - Country:US
Mailing Address - Phone:407-296-1902
Mailing Address - Fax:407-358-5366
Practice Address - Street 1:1151 BLACKWOOD AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4519
Practice Address - Country:US
Practice Address - Phone:407-296-1902
Practice Address - Fax:407-358-5366
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83805208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13121Medicare ID - Type Unspecified
FLH71360Medicare UPIN