Healthcare Provider Details

I. General information

NPI: 1174450118
Provider Name (Legal Business Name): SALUD ACO 1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 SW 148TH AVE STE 202
MIRAMAR FL
33027-3239
US

IV. Provider business mailing address

3350 SW 148TH AVE STE 202
MIRAMAR FL
33027-3239
US

V. Phone/Fax

Practice location:
  • Phone: 954-231-5141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN GRUNER
Title or Position: SOLE MBR
Credential:
Phone: 954-231-5141