Provider Demographics
NPI:1699186551
Name:MASGHATI, SALOME (MD)
Entity type:Individual
Prefix:
First Name:SALOME
Middle Name:
Last Name:MASGHATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13013 SEMINOLE BLVD
Mailing Address - Street 2:#1102
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778
Mailing Address - Country:US
Mailing Address - Phone:323-307-6640
Mailing Address - Fax:727-516-6648
Practice Address - Street 1:13013 SEMINOLE BLVD
Practice Address - Street 2:#1102
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778
Practice Address - Country:US
Practice Address - Phone:323-307-6640
Practice Address - Fax:727-516-6648
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19380207V00000X
CA390200000X
MDD0090220207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program