MEDICARE: DR. AFONSO SHIGUEMI INOUE SALGADO SR. PA

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	363A00000X	Physician Assistant	002776-P.A.	PR

General Provider Information

NPI Number	:	1689526881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AFONSO SHIGUEMI INOUE SALGADO SR. PA

Provider Business Mailing Address
First Line	:	12767 WESTSIDE VILLAGE LOOP
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-6775
Country	:	US
Telephone Number	:	321-315-1049
Fax Number	:

Provider Business Practice Location Address
First Line	:	6735 CONROY RD STE 424
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3566
Country	:	US
Telephone Number	:	407-415-9106
Fax Number	:

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

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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