Provider Demographics
NPI:1619167004
Name:SALCEDO VARELA, JAIME MAURICIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:MAURICIO
Last Name:SALCEDO VARELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-533-6837
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:1049 W ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3482
Practice Address - Country:US
Practice Address - Phone:407-884-2952
Practice Address - Fax:407-884-9352
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME112467207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLKW586OtherMEDICARE
FL006427600Medicaid
FLFS0884216OtherDEA NUMBER
FLGP912ZMedicare PIN