Healthcare Provider Details

I. General information

NPI: 1740044858
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E SAMPLE RD STE 107
POMPANO BEACH FL
33064-4443
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 954-210-7016
  • Fax: 954-785-0755
Mailing address:
  • Phone: 954-967-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DARLENE NEEL
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 954-967-6400