Provider Demographics
NPI:1629649348
Name:SALAS, MARIA JOSE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE
Last Name:SALAS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14323 SW 272ND LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8894
Mailing Address - Country:US
Mailing Address - Phone:786-486-1182
Mailing Address - Fax:
Practice Address - Street 1:14323 SW 272ND LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8894
Practice Address - Country:US
Practice Address - Phone:786-486-1182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-03
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012548208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice