MEDICARE: SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, 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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1770202384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC

Provider Business Mailing Address
First Line	:	900 S PINE ISLAND RD STE 800
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3923
Country	:	US
Telephone Number	:	954-967-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2370 DREW ST STE B
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-3318
Country	:	US
Telephone Number	:	727-461-1543
Fax Number	:	727-449-0594

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	DARLENE NEEL
Credential	:
Telephone Number	:	954-967-6400

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	08/25/2022

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