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NPI Code Detail

MEDICARE: CHRISTIAN G BOLANOS SALAZAR M.D

MEDICARE:   CHRISTIAN G BOLANOS SALAZAR  M.D
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
1207RN0300XNephrology PhysicianME149154FL
2207RN0300XNephrology PhysicianA149943CA
3207R00000XInternal Medicine Physician260304MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962818807
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN G BOLANOS SALAZAR M.D
Provider Business Mailing Address
First Line : 6914 SHELDON RD STE 101
Second Line :
City : TAMPA
State : FL
Zip : 33615-2701
Country : US
Telephone Number : 813-910-0030
Fax Number : 813-442-6530
Provider Business Practice Location Address
First Line : 6914 SHELDON RD STE 101
Second Line :
City : TAMPA
State : FL
Zip : 33615-2701
Country : US
Telephone Number : 813-910-0030
Fax Number : 813-971-6473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2014
Last Update Date : 10/30/2025

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Directions to “ CHRISTIAN G BOLANOS SALAZAR M.D” Practice Location

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