MEDICARE: SUZETTE SALMON

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	164W00000X	Licensed Practical Nurse	PN 5150062	FL

General Provider Information

NPI Number	:	1932221017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZETTE SALMON

Provider Business Mailing Address
First Line	:	6246 SAXON BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6246 SAXON BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5436
Country	:	US
Telephone Number	:	561-684-9247
Fax Number	:

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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Directions to “ SUZETTE SALMON ” Practice Location

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