MEDICARE: SALTY HEALTHCARE, 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1114877818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALTY HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	1883 W ROYAL HUNTE DR STE 200A
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-4000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1883 W ROYAL HUNTE DR STE 200A
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-4000
Country	:	US
Telephone Number	:	561-336-0305
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZANDA SALT SERRANO
Credential	:	ARNP
Telephone Number	:	561-336-0305

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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