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General NPI Number Information
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NPI Number | 1831255991
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Entity Type | Individual
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Provider Name | ENRIQUE SALAZAR FERNANDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/30/2006
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 10271 SW 72ND ST # D-102
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City | MIAMI
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State | FL
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Zip | 33173-3024
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Country | US
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Telephone | 305-226-4048
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Fax |
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Provider Business Mailing Address
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Address Line | 12401 SW 43RD ST
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City | MIAMI
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State | FL
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Zip | 33175-4213
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Country | US
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Telephone | 305-720-6022
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME80356
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License Number State | FL
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