Provider Demographics
NPI:1639202302
Name:JESSE SALMERON MD PA
Entity Type:Organization
Organization Name:JESSE SALMERON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-652-8151
Mailing Address - Street 1:PO BOX 640885
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33164-0885
Mailing Address - Country:US
Mailing Address - Phone:305-652-8151
Mailing Address - Fax:305-651-7257
Practice Address - Street 1:3363 NE 163RD ST STE 505
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4423
Practice Address - Country:US
Practice Address - Phone:305-652-8151
Practice Address - Fax:305-651-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAD848Medicare PIN