Provider Demographics
NPI:1568600294
Name:SALAVERRIA, GLADYS CAROLINA (MS)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:CAROLINA
Last Name:SALAVERRIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:GLADYS
Other - Middle Name:CAROLINA
Other - Last Name:RIEDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7397
Mailing Address - Country:US
Mailing Address - Phone:305-279-2428
Mailing Address - Fax:305-596-9996
Practice Address - Street 1:8600 SW 92ND ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7397
Practice Address - Country:US
Practice Address - Phone:305-279-2428
Practice Address - Fax:305-596-9996
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist