Healthcare Provider Details

I. General information

NPI: 1891903464
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTEL, LEVIN AND JACOBSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 LYONS RD 110
COCONUT CREEK FL
33073-3481
US

IV. Provider business mailing address

900 S PINE ISLAND RD 800
PLANTATION FL
33324-3920
US

V. Phone/Fax

Practice location:
  • Phone: 954-971-3210
  • Fax: 954-971-3427
Mailing address:
  • Phone: 954-971-3210
  • Fax: 954-971-3427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA CORSIATTO
Title or Position: DIRECTOR
Credential:
Phone: 954-967-6400