MEDICARE: MINDY JAN SALTZMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW4888	FL

General Provider Information

NPI Number	:	1023165164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY JAN SALTZMAN LCSW

Provider Business Mailing Address
First Line	:	7289 GARDEN RD
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-4917
Country	:	US
Telephone Number	:	561-385-5868
Fax Number	:

Provider Business Practice Location Address
First Line	:	7289 GARDEN RD
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-4917
Country	:	US
Telephone Number	:	561-804-7900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/14/2007

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