Provider Demographics
NPI:1457857096
Name:LESLOM, SALMAN NASSER
Entity type:Individual
Prefix:
First Name:SALMAN
Middle Name:NASSER
Last Name:LESLOM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S OSPREY AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3608
Mailing Address - Country:US
Mailing Address - Phone:480-516-7791
Mailing Address - Fax:
Practice Address - Street 1:1801 S OSPREY AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3608
Practice Address - Country:US
Practice Address - Phone:480-516-7791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1603212085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology