Healthcare Provider Details

I. General information

NPI: 1871395574
Provider Name (Legal Business Name): NICOLE ARIADNE MORALES SALINA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 JFK DR STE 102
ATLANTIS FL
33462-6604
US

IV. Provider business mailing address

160 JFK DR STE 102
ATLANTIS FL
33462-6604
US

V. Phone/Fax

Practice location:
  • Phone: 561-439-0961
  • Fax: 561-439-0963
Mailing address:
  • Phone: 561-439-0961
  • Fax: 561-439-0963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: