MEDICARE: DR. HOMERO MARIN SALVADOR MD

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	208D00000X	General Practice Physician	ACN1498	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ACN1498	OTHER	FL	MEDICAL LIC

General Provider Information

NPI Number	:	1518674332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOMERO MARIN SALVADOR MD

Provider Business Mailing Address
First Line	:	6101 WEBB RD STE 311
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2866
Country	:	US
Telephone Number	:	656-256-1487
Fax Number	:	656-789-4155

Provider Business Practice Location Address
First Line	:	6101 WEBB RD STE 311
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2866
Country	:	US
Telephone Number	:	656-256-1487
Fax Number	:	656-789-4155

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

Provider Enumeration Date	:	11/01/2022
Last Update Date	:	01/21/2026

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