Healthcare Provider Details
I. General information
NPI: 1669458949
Provider Name (Legal Business Name): IGNACIO J R SALZMAN MD P A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2005
Last Update Date: 03/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9430 TURKEY LAKE RD SUITE216
ORLANDO FL
32819-8015
US
IV. Provider business mailing address
9430 TURKEY LAKE RD SUITE216
ORLANDO FL
32819-8015
US
V. Phone/Fax
- Phone: 407-354-4470
- Fax: 407-354-4584
- Phone: 407-354-4470
- Fax: 407-354-4584
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
IGNACIO
J
SALZMAN
Title or Position: PROVIDER OWNER
Credential: MD
Phone: 407-354-4470