Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME91793 | FL |
N | 111NI0900X | Internist | ME91793 | FL |
Y | 207RG0300X | Geriatric Medicine | ME91793 | FL |
N | 207RH0002X | Hospice and Palliative Medicine | ME91793 | FL |
NPI | 1215900931 |
---|---|
Provider Name | Carlos Alberto Salazar |
First Address | Tampa, FL 33614-7152 |
Second Address | Tampa, FL 33614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 17/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
273706000 | (05) | FL |