Provider Demographics
NPI:1174255160
Name:SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Entity Type:Organization
Organization Name:SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-967-6400
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-967-6400
Mailing Address - Fax:
Practice Address - Street 1:4400 W SAMPLE RD STE 122
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3457
Practice Address - Country:US
Practice Address - Phone:954-978-6130
Practice Address - Fax:954-978-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty