Healthcare Provider Details

I. General information

NPI: 1598572513
Provider Name (Legal Business Name): SALMA RAWOF MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9161 NARCOOSSEE RD # B209
ORLANDO FL
32827-5764
US

IV. Provider business mailing address

9304 MUSTARD LEAF DR
ORLANDO FL
32827-7082
US

V. Phone/Fax

Practice location:
  • Phone: 321-222-6261
  • Fax:
Mailing address:
  • Phone: 352-577-2562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SALMA RAWOF
Title or Position: OWNER CEO
Credential: MD
Phone: 352-577-2562