Healthcare Provider Details
I. General information
NPI: 1538685656
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2017
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1193 W 49TH ST
HIALEAH FL
33012-3337
US
IV. Provider business mailing address
900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US
V. Phone/Fax
- Phone: 305-777-9190
- Fax: 305-779-0729
- Phone: 954-965-7331
- Fax: 954-965-7339
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PETER
J
SHULMAN
Title or Position: CEO
Credential: MD
Phone: 954-967-6400