MEDICARE: ENRIQUE SALAZAR FERNANDEZ 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	207Q00000X	Family Medicine Physician	ME80356	FL

General Provider Information

NPI Number	:	1831255991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENRIQUE SALAZAR FERNANDEZ MD

Provider Business Mailing Address
First Line	:	12401 SW 43RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4213
Country	:	US
Telephone Number	:	305-720-6022
Fax Number	:

Provider Business Practice Location Address
First Line	:	10271 SW 72ND ST # D-102
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3024
Country	:	US
Telephone Number	:	305-226-4048
Fax Number	:

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

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	07/19/2013

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