Healthcare Provider Details

I. General information

NPI: 1598895252
Provider Name (Legal Business Name): GEORGES N SALIBA M.D. P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11880 SW 40TH ST
MIAMI FL
33175-3584
US

IV. Provider business mailing address

4661 SW 153RD CT
MIAMI FL
33185-5225
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-3131
  • Fax:
Mailing address:
  • Phone: 786-554-1055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME70901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: