Provider Demographics
NPI:1669458949
Name:IGNACIO J R SALZMAN MD P A
Entity Type:Organization
Organization Name:IGNACIO J R SALZMAN MD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IGNACIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-354-4470
Mailing Address - Street 1:9430 TURKEY LAKE RD
Mailing Address - Street 2:SUITE216
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8015
Mailing Address - Country:US
Mailing Address - Phone:407-354-4470
Mailing Address - Fax:407-354-4584
Practice Address - Street 1:9430 TURKEY LAKE RD
Practice Address - Street 2:SUITE216
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8015
Practice Address - Country:US
Practice Address - Phone:407-354-4470
Practice Address - Fax:407-354-4584
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IGNACIO SALZMAN MD P A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-19
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty