Healthcare Provider Details

I. General information

NPI: 1114877818
Provider Name (Legal Business Name): SALTY HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 TAYLOR LN
LEHIGH ACRES FL
33936
US

IV. Provider business mailing address

1065 SW 8TH ST # 2586
MIAMI FL
33130-3601
US

V. Phone/Fax

Practice location:
  • Phone: 561-336-0305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZANDA SALT SERRANO
Title or Position: OWNER
Credential: ARNP
Phone: 561-336-0305