Healthcare Provider Details

I. General information

NPI: 1558457317
Provider Name (Legal Business Name): SALOMON ESQUENAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 SW 37TH AVE
MIAMI FL
33145-3051
US

IV. Provider business mailing address

2441 SW 37TH AVE
MIAMI FL
33145-3051
US

V. Phone/Fax

Practice location:
  • Phone: 305-442-0066
  • Fax: 305-445-6896
Mailing address:
  • Phone: 305-442-0066
  • Fax: 305-445-6896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0090955
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME90955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: