Provider Demographics
NPI:1235177213
Name:BRUCE L. SALTZ, M.D., P.A.
Entity Type:Organization
Organization Name:BRUCE L. SALTZ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/ASSISTANT ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:FEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:DINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-368-8430
Mailing Address - Street 1:4800 N FEDERAL HWY
Mailing Address - Street 2:SUITE 102E
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5188
Mailing Address - Country:US
Mailing Address - Phone:561-368-8430
Mailing Address - Fax:561-362-5575
Practice Address - Street 1:4800 N FEDERAL HWY
Practice Address - Street 2:SUITE 102E
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5188
Practice Address - Country:US
Practice Address - Phone:561-368-8430
Practice Address - Fax:561-362-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7917103TB0200X
FLME00565152084P0800X, 2084P0805X
FLARNP 2623662364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40240OtherBC/BS FL GROUP NO.
FL=========OtherEIN NUMBER
FL40240Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER