Provider Demographics
NPI:1558441907
Name:SALAS, YANIRA E (DPM)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:E
Last Name:SALAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 SW 87 AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176
Mailing Address - Country:US
Mailing Address - Phone:305-412-2445
Mailing Address - Fax:305-412-2446
Practice Address - Street 1:9300 SW 87 AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-412-2445
Practice Address - Fax:305-412-2446
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0002593213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340067100Medicaid
FL65533OtherBCBS
FL65533AMedicare ID - Type Unspecified
FL65533OtherBCBS