Provider Demographics
NPI:1598334385
Name:SALAZAR, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:SALAZAR
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:URB. LEVITTOWN LAKES
Mailing Address - Street 2:CALLE EDUARDO FRANKILN #HJ-6
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3625
Mailing Address - Country:US
Mailing Address - Phone:787-671-5363
Mailing Address - Fax:
Practice Address - Street 1:URB. LEVITTOWN LAKES
Practice Address - Street 2:CALLE EDUARDO FRANKILN #HJ-6
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3625
Practice Address - Country:US
Practice Address - Phone:787-671-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22324208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice