Healthcare Provider Details

I. General information

NPI: 1306022082
Provider Name (Legal Business Name): LISA SALVATI MD MPH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2008
Last Update Date: 01/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13455 MILITARY TRL SUITE A
DELRAY BEACH FL
33484-1320
US

IV. Provider business mailing address

13455 MILITARY TRL SUITE A
DELRAY BEACH FL
33484-1320
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-4644
  • Fax: 561-495-5191
Mailing address:
  • Phone: 561-495-4644
  • Fax: 561-495-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME55134
License Number StateFL

VIII. Authorized Official

Name: LISA SALVATI
Title or Position: OWNER
Credential: M.D.
Phone: 561-495-4644