Healthcare Provider Details

I. General information

NPI: 1881442754
Provider Name (Legal Business Name): LEILA SALAZAR HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7019 HARPS MILL RD STE 100
RALEIGH NC
27615-3248
US

IV. Provider business mailing address

7019 HARPS MILL RD STE 100
RALEIGH NC
27615-3248
US

V. Phone/Fax

Practice location:
  • Phone: 919-844-6000
  • Fax: 919-844-6616
Mailing address:
  • Phone: 919-844-6000
  • Fax: 919-844-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1574
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: