MEDICARE: SAL-LEO INC.

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	207Q00000X	Family Medicine Physician	9268	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9268	OTHER	NV	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	G57380	OTHER	NV	UPIN

General Provider Information

NPI Number	:	1629250881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAL-LEO INC.

Provider Business Mailing Address
First Line	:	3100 W CHARLESTON BLVD STE 205
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1900
Country	:	US
Telephone Number	:	702-258-4469
Fax Number	:	702-259-0239

Provider Business Practice Location Address
First Line	:	3100 W CHARLESTON BLVD STE 205
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1900
Country	:	US
Telephone Number	:	702-258-4469
Fax Number	:	702-259-0239

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FRANCIS ESCOLIN JIMENEZ
Credential	:	M.D.
Telephone Number	:	702-285-4469

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	02/07/2014

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Directions to “SAL-LEO INC. ” Practice Location

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