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NPI Code Detail

MEDICARE: SERGIO AGUSTIN SALAZAR M.D.

MEDICARE: SERGIO AGUSTIN SALAZAR M.D.
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
1207R00000XInternal Medicine Physician21574TN
2207R00000XInternal Medicine PhysicianME103578FL

General Provider Information

NPI Number : 1679591838
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERGIO AGUSTIN SALAZAR M.D.
Provider Business Mailing Address
First Line : 3400 QUADRANGLE BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32817-1492
Country : US
Telephone Number : 407-266-3627
Fax Number : 407-882-4799
Provider Business Practice Location Address
First Line : 3400 QUADRANGLE BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32817-1492
Country : US
Telephone Number : 407-266-3627
Fax Number : 407-882-4799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 12/10/2015

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