Provider Demographics
NPI:1083735401
Name:GRIMALDI, SALVATORE LOUIS (DO)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:LOUIS
Last Name:GRIMALDI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 45TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2450
Mailing Address - Country:US
Mailing Address - Phone:561-848-5579
Mailing Address - Fax:561-848-9269
Practice Address - Street 1:927 45TH ST STE 101
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2450
Practice Address - Country:US
Practice Address - Phone:561-848-5579
Practice Address - Fax:561-848-9269
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016166207Y00000X
FLOS10621207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology