Healthcare Provider Details

I. General information

NPI: 1407023310
Provider Name (Legal Business Name): SALVATORE JOSEPH BUONAIUTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E. ROLLINS ST. FLORIDA HOSPITAL FOR CHILDREN
ORLANDO FL
32803
US

IV. Provider business mailing address

1033 DR MARTIN LUTHER KING JR ST N SUITE 108
ST PETERSBURG FL
33701-1547
US

V. Phone/Fax

Practice location:
  • Phone: 407-599-2700
  • Fax:
Mailing address:
  • Phone: 727-456-3288
  • Fax: 727-456-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number8209555-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number8209555-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME117929
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: