Provider Demographics
NPI:1164620696
Name:SALAS, NEIL ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:ALEJANDRO
Last Name:SALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SW 84TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2736
Mailing Address - Country:US
Mailing Address - Phone:954-452-5850
Mailing Address - Fax:954-452-5818
Practice Address - Street 1:140 SW 84TH AVE STE D
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2736
Practice Address - Country:US
Practice Address - Phone:954-452-5850
Practice Address - Fax:954-452-5818
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.122102207V00000X
FLME131178207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104435Medicaid
OHH322990Medicare PIN