Provider Demographics
NPI:1164726501
Name:MARC ALAN SALTZMAN MD PA
Entity Type:Organization
Organization Name:MARC ALAN SALTZMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-933-1113
Mailing Address - Street 1:20880 W DIXIE HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1151
Mailing Address - Country:US
Mailing Address - Phone:305-757-2226
Mailing Address - Fax:305-759-4707
Practice Address - Street 1:17971 BISCAYNE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2532
Practice Address - Country:US
Practice Address - Phone:305-933-1113
Practice Address - Fax:305-759-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME20954207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
EN694AMedicare UPIN