Healthcare Provider Details

I. General information

NPI: 1437508942
Provider Name (Legal Business Name): ALLISON ROSE SALIB D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 RAND BLVD
SARASOTA FL
34238-5160
US

IV. Provider business mailing address

3116 BUTTONWOOD PL
PUNTA GORDA FL
33950-7022
US

V. Phone/Fax

Practice location:
  • Phone: 941-893-6620
  • Fax: 941-556-5850
Mailing address:
  • Phone: 609-548-0093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS16036
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberOS16036
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: