Provider Demographics
NPI:1144421249
Name:SALCEDO, MARITZA (MD)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:SALCEDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B576 AVE ARTERIAL
Mailing Address - Street 2:THE COLISEUM TOWER APT 2106
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-755-0405
Mailing Address - Fax:
Practice Address - Street 1:638 CALLE LARINAGA
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00977
Practice Address - Country:US
Practice Address - Phone:787-755-0405
Practice Address - Fax:787-755-0735
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16654208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice