MEDICARE: SALUD INTEGRATED MEDICINE ASSOCIATES, LLC

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	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1073285631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALUD INTEGRATED MEDICINE ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	55 W CHURCH ST APT 1415
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-4915
Country	:	US
Telephone Number	:	407-970-7026
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 W FAIRBANKS AVE STE 212
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-4547
Country	:	US
Telephone Number	:	407-970-7026
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	XAVIER M IRIZARRY
Credential	:
Telephone Number	:	407-970-7026

Provider Enumeration Date	:	10/01/2021
Last Update Date	:	10/01/2021

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