Healthcare Provider Details

I. General information

NPI: 1245484351
Provider Name (Legal Business Name): LUIS M SALMUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 NE 18TH ST UNIT 4911
MIAMI FL
33132-1339
US

IV. Provider business mailing address

488 NE 18TH ST UNIT 4911
MIAMI FL
33132-1339
US

V. Phone/Fax

Practice location:
  • Phone: 561-322-8503
  • Fax:
Mailing address:
  • Phone: 561-322-8503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA06986500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME125929
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberME125929
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME125929
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: