Healthcare Provider Details

I. General information

NPI: 1376618561
Provider Name (Legal Business Name): JHONNY ABRAHAM SALOMON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 SW 57TH AVE SUITE 708
SOUTH MIAMI FL
33143-3622
US

IV. Provider business mailing address

6705 S.W. 57TH AVE, SUITE 708
CORAL GABLES FL
33140
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-1361
  • Fax: 305-270-9138
Mailing address:
  • Phone: 305-772-4480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberFLME0074882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: