Healthcare Provider Details

I. General information

NPI: 1609802008
Provider Name (Legal Business Name): ANTHONY J SALVADOR P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 02/21/2022
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3313 W HILLSBORO BLVD STE 202
DEERFIELD BEACH FL
33442-9423
US

IV. Provider business mailing address

3313 W HILLSBORO BLVD STE 202
DEERFIELD BEACH FL
33442-9423
US

V. Phone/Fax

Practice location:
  • Phone: 954-571-9500
  • Fax: 954-571-9560
Mailing address:
  • Phone: 954-571-9500
  • Fax: 954-571-9560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 9101025
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: