Healthcare Provider Details

I. General information

NPI: 1760739833
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15077 S DIXIE HWY
PALMETTO BAY FL
33176-7930
US

IV. Provider business mailing address

900 S PINE ISLAND RD 800
PLANTATION FL
33324-3920
US

V. Phone/Fax

Practice location:
  • Phone: 786-293-3200
  • Fax: 786-293-8819
Mailing address:
  • Phone: 786-293-3200
  • Fax: 786-293-8819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA CORSIATTO
Title or Position: DIRECTOR
Credential:
Phone: 954-967-6400