Shady Salib MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SHADY SALIB MD LLC

Practice address

3345 Burns Rd Ste 204
Palm Beach Gardens, FL 33410-4306

Phone

(561) 622-7604

NPI assigned

Jun 23, 2022

Organization subpart

No

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

Authorized official

Name

Shady Salib, MD

Title

Owner

Phone

(561) 901-0429

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1194456665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD STE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104306",
            "telephone_number": "561-622-7604",
            "fax_number": "561-622-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD STE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104306",
            "telephone_number": "561-622-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY SALIB MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "SALIB",
        "authorized_official_first_name": "SHADY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-901-0429",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.fmcpb.com/contact",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "AMIR FAHMY MD PA",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Contact",
            "address_1": "3345 Burns Rd Ste 204",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334104306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.