Healthcare Provider Details

I. General information

NPI: 1356559025
Provider Name (Legal Business Name): SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 N PARK DR STE 101
WESTON FL
33326-3294
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 954-389-7000
  • Fax: 954-389-8726
Mailing address:
  • Phone: 954-389-7000
  • Fax: 954-389-8726

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