Healthcare Provider Details

I. General information

NPI: 1538817390
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTEL, LEVIN AND JACOBSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/11/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16250 NW 57TH AVE
MIAMI LAKES FL
33014-6711
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 786-442-2136
  • Fax: 305-823-0914
Mailing address:
  • Phone: 786-442-2136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DARLENE NEEL
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 954-967-6400