Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME 121584 | FL |
N | 207QA0505X | Family Doctor - Adult Medicine | 73055 | GA |
NPI | 1336496272 |
---|---|
Provider Name | Armando J Salazar |
First Address | Atlanta, GA 30329-3722 |
Second Address | Miramar, FL 33027-6308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2012 |
Last Update Date | 08/03/2016 |