MEDICARE: DR. JAMAL SALIBA SALAMEH MD

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	207R00000X	Internal Medicine Physician	ME81937	FL
2	207RN0300X	Nephrology Physician	ME81937	FL

General Provider Information

NPI Number	:	1174558753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMAL SALIBA SALAMEH MD

Provider Business Mailing Address
First Line	:	PO BOX 57189
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32241-7189
Country	:	US
Telephone Number	:	904-744-4448
Fax Number	:	904-744-4048

Provider Business Practice Location Address
First Line	:	4123 UNIVERSITY BLVD S STE E
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4320
Country	:	US
Telephone Number	:	904-744-7300
Fax Number	:	904-744-4048

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/28/2020

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