Individual provider Active NPI

Edward Salib, D.O.

  • Family Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1073867941
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
UO 3009 Issued in FL
Practice address
2626 Tampa Rd
Ste 101
Palm Harbor, FL 34684-3110
Phone
(727) 754-1984
Fax
(727) 754-2868
NPI assigned
Oct 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X UO 3009 FL Primary

Addresses

Primary practice location

2626 Tampa Rd
Ste 101
Palm Harbor, FL 34684-3110

Mailing address

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014002987 FL Practitioner - Family Practice 9931418902 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
UO 3009FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crestview Hospital Company, LLC CurrentSince Aug 1, 2015 Accepting new patients
VMD Primary Providers Central Florida PLLC Family Medicine CurrentSince Mar 21, 2022 Accepting new patients
Premier Inpatient Partners LLC CurrentSince Feb 1, 2020 Accepting new patients
Crestview Hospital Company LLC Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Dwic of Tampa Bay, Inc Past Accepting new patients
VMD Primary Providers Central Florida PLLC Family Medicine PastSince May 8, 2022 Accepting new patients
Heathrow Internal Medicine LLC Family Medicine Past Accepting new patients

Locations

4404 S Highway 27
Clermont, FL 34711

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

1060 Woodcock Rd
Ste 128
Orlando, FL 32803
Phone (346) 980-2725

3550 Fruitville Rd
Sarasota, FL 34237
Phone (941) 955-4282

4650 Westway Park Blvd
Ste 206
Houston, TX 77041
Phone (346) 980-2725

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14267/brand/6/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1073867941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 TAMPA RD",
            "address_2": "STE 101",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843110",
            "telephone_number": "727-754-1984",
            "fax_number": "727-754-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIB",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "UO 3009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.