Healthcare Provider Details

I. General information

NPI: 1235177213
Provider Name (Legal Business Name): BRUCE L. SALTZ, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 N FEDERAL HWY SUITE 102E
BOCA RATON FL
33431-5188
US

IV. Provider business mailing address

4800 N FEDERAL HWY SUITE 102E
BOCA RATON FL
33431-5188
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-8430
  • Fax: 561-362-5575
Mailing address:
  • Phone: 561-368-8430
  • Fax: 561-362-5575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME0056515
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberARNP 2623662
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY7917
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME0056515
License Number StateFL

VIII. Authorized Official

Name: MS. FEBE DINO
Title or Position: OFFICE MANAGER/ASSISTANT ACCOUNTANT
Credential:
Phone: 561-368-8430