Healthcare Provider Details

I. General information

NPI: 1013037647
Provider Name (Legal Business Name): CARL A SALVATI M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/14/2013
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 Code2084N0400X
TaxonomyNeurology Physician
License NumberME0050473
License Number StateFL

VIII. Authorized Official

Name: CARL SALVATI
Title or Position: PHYSICIAN
Credential: MD
Phone: 561-495-4644