Healthcare Provider Details

I. General information

NPI: 1417116195
Provider Name (Legal Business Name): SALEEM SAIYAD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13624 W HILLSBOROUGH AVE
TAMPA FL
33635-9638
US

IV. Provider business mailing address

3905 TAMPA RD UNIT 1189
OLDSMAR FL
34677-9750
US

V. Phone/Fax

Practice location:
  • Phone: 813-818-0100
  • Fax: 813-818-0144
Mailing address:
  • Phone: 813-818-0100
  • Fax: 813-818-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME88082
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME88082
License Number StateFL

VIII. Authorized Official

Name: SALEEM SAIYAD
Title or Position: OWNER
Credential: M.D.
Phone: 813-507-5349