Healthcare Provider Details

I. General information

NPI: 1861826687
Provider Name (Legal Business Name): RICARDO ANTONIO SALDANA AA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 FAIRWAY DR SUITE 450
PALM BEACH GARDENS FL
33418-4204
US

IV. Provider business mailing address

PO BOX 21215
WEST PALM BEACH FL
33416-1215
US

V. Phone/Fax

Practice location:
  • Phone: 561-799-3552
  • Fax:
Mailing address:
  • Phone: 561-319-4834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA166
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: