Provider Demographics
NPI:1285632315
Name:SALGADO-DIAZ, LUIS R (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:R
Last Name:SALGADO-DIAZ
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:CALLE 1
Mailing Address - Street 2:# 104 PASEO LAS VISTAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-1700
Mailing Address - Country:US
Mailing Address - Phone:939-639-6910
Mailing Address - Fax:787-760-8544
Practice Address - Street 1:CALLE 1
Practice Address - Street 2:# 104 PASEO LAS VISTAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-1700
Practice Address - Country:US
Practice Address - Phone:939-639-6910
Practice Address - Fax:787-760-8544
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8624146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-0689OtherBLUE SHIELD
PR80689Medicare ID - Type Unspecified