Healthcare Provider Details

I. General information

NPI: 1336496272
Provider Name (Legal Business Name): ARMANDO J SALAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 SW 160TH AVE SUITE 250
MIRAMAR FL
33027-6308
US

IV. Provider business mailing address

3369 BUFORD HIGHWAY SUITE 810
ATLANTA GA
30329-3722
US

V. Phone/Fax

Practice location:
  • Phone: 877-866-7123
  • Fax: 855-855-2792
Mailing address:
  • Phone: 404-321-4692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number73055
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 121584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: