Healthcare Provider Details

I. General information

NPI: 1588999825
Provider Name (Legal Business Name): HAMISU SALIHU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W BUSCH BLVD
TAMPA FL
33618-4523
US

IV. Provider business mailing address

7903 TERRACE RIDGE DR
TEMPLE TERRACE FL
33637-3001
US

V. Phone/Fax

Practice location:
  • Phone: 813-936-9326
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME102530
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME102530
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: