Healthcare Provider Details

I. General information

NPI: 1851647986
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2012
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 NW 41ST ST
DORAL FL
33178-2973
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 305-436-1563
  • Fax: 305-436-1564
Mailing address:
  • Phone: 305-436-1563
  • Fax: 305-436-1564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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