MEDICARE: RAHIM SALARI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	ME30408	FL

General Provider Information

NPI Number	:	1043215577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAHIM SALARI M.D.

Provider Business Mailing Address
First Line	:	6563 CRESCENT LAKE DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-4654
Country	:	US
Telephone Number	:	863-604-6575
Fax Number	:

Provider Business Practice Location Address
First Line	:	6563 CRESCENT LAKE DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-4654
Country	:	US
Telephone Number	:	863-604-6575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	05/13/2020

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