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General NPI Number Information
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NPI Number | 1871591180
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Entity Type | Individual
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Provider Name | SALVATORE ANZALONE MD, PACOG
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Gender | Male
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 3425 10TH ST N
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City | NAPLES
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State | FL
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Zip | 34103-3866
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Country | US
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Telephone | 239-262-1066
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Fax | 239-262-2031
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Provider Business Mailing Address
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Address Line | 1454 MADISON AVE W
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City | IMMOKALEE
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State | FL
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Zip | 34142-2200
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Country | US
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Telephone | 239-658-3064
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Fax | 239-658-3175
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME117687
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License Number State | FL
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