Healthcare Provider Details

I. General information

NPI: 1104932482
Provider Name (Legal Business Name): MARTHA ISABEL SALAZAR I PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST MIAMI VA HEALTHCARE SYSTEM, PHARMACY (119)
MIAMI FL
33125-1624
US

IV. Provider business mailing address

3114 NW 101ST CT
DORAL FL
33172-5917
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-4455
  • Fax: 305-575-3386
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS 36738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: