Healthcare Provider Details

I. General information

NPI: 1548372733
Provider Name (Legal Business Name): SALVATORE MUSUMECI JR. BBA, RDCS, RDMS, RVT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. SALVATORE MUSUMECI JR.

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MIRAMAR DR
DELRAY BEACH FL
33483-6927
US

IV. Provider business mailing address

7378 W ATLANTIC BLVD # 398
MARGATE FL
33063-4214
US

V. Phone/Fax

Practice location:
  • Phone: 561-276-1125
  • Fax: 561-276-7698
Mailing address:
  • Phone: 954-871-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number51079
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: