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General NPI Number Information
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NPI Number | 1003797473
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Entity Type | Individual
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Provider Name | BRYAN SALDARRIAGA PA
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Gender | Male
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 35 HOSPITAL RD
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3139
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Country | US
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Telephone | 706-745-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 8341 NW 80TH PL
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City | TAMARAC
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State | FL
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Zip | 33321-1636
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Country | US
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Telephone | 954-851-5887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PENDING
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License Number State | GA
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