Individual provider Active NPI

Isra M Saleh-Mohd, PSYD

  • Clinical Psychologist
  • Lutz, FL
National Provider Identifier
1457532764
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7588 Issued in FL
Practice address
18958 Dale Mabry Hwy N
Suite102
Lutz, FL 33548-4911
Phone
(813) 541-9096
Fax
(813) 319-3933
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7588 FL Primary

Addresses

Primary practice location

18958 Dale Mabry Hwy N
Suite102
Lutz, FL 33548-4911

Mailing address

7812 Bally Money Rd
Tampa, FL 33610-8067
Phone (813) 541-9096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY7588FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1457532764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7812 BALLY MONEY RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336108067",
            "telephone_number": "813-541-9096",
            "fax_number": "813-319-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18958 DALE MABRY HWY N",
            "address_2": "SUITE102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484911",
            "telephone_number": "813-541-9096",
            "fax_number": "813-319-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEH-MOHD",
        "first_name": "ISRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.