MEDICARE: MRS. MARIRENE MARGARITA SALAZAR P.A.

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	363AM0700X	Medical Physician Assistant	PA9103693	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00769974	OTHER	FL	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1689776072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIRENE MARGARITA SALAZAR P.A.

Provider Business Mailing Address
First Line	:	300 71 STREET
Second Line	:	SUITE 620
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-3089
Country	:	US
Telephone Number	:	954-554-8087
Fax Number	:	877-284-8933

Provider Business Practice Location Address
First Line	:	2731 EXECUTIVE PARK DR STE 4
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3619
Country	:	US
Telephone Number	:	954-302-8382
Fax Number	:	954-626-3658

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

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	06/10/2025

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