=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477629327
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAZEED FOUAD SALEH MSRPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/24/2006
-----------------------------------------------------
Last Update Date | 01/24/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2098 HENLEY PL
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-7757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-352-6199
-----------------------------------------------------
Fax | 561-352-6199
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2098 HENLEY PL
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-7757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-352-6199
-----------------------------------------------------
Fax | 561-790-2094
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | PT10718
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------