Healthcare Provider Details

I. General information

NPI: 1982949525
Provider Name (Legal Business Name): NILDELENE SALAZAR MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2012
Last Update Date: 12/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SW 27TH AVE STE 208
MIAMI FL
33145-2455
US

IV. Provider business mailing address

2460 SW 18TH AVE APT 1101
MIAMI FL
33145-3846
US

V. Phone/Fax

Practice location:
  • Phone: 786-554-9567
  • Fax:
Mailing address:
  • Phone: 786-554-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: