Provider Demographics
NPI:1568090876
Name:VENTURA SALGADO, ILIANET (MD)
Entity Type:Individual
Prefix:
First Name:ILIANET
Middle Name:
Last Name:VENTURA SALGADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1979 W HILLSBORO BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1444
Mailing Address - Country:US
Mailing Address - Phone:954-710-6514
Mailing Address - Fax:
Practice Address - Street 1:1979 W HILLSBORO BLVD STE 1
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1444
Practice Address - Country:US
Practice Address - Phone:954-710-6514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162858207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program