Provider Demographics
NPI:1225700602
Name:NEKLEWICZ SALEM, SANDRA A (CNA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:NEKLEWICZ SALEM
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SW 13TH DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-5368
Mailing Address - Country:US
Mailing Address - Phone:561-562-1054
Mailing Address - Fax:
Practice Address - Street 1:1401 SW 13TH DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-5368
Practice Address - Country:US
Practice Address - Phone:561-562-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA399099376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide