Provider Demographics
NPI:1689740714
Name:SALAZAR-VUST, CLARA AURORA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:AURORA
Last Name:SALAZAR-VUST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4375 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2643
Mailing Address - Country:US
Mailing Address - Phone:305-441-0947
Mailing Address - Fax:305-444-7184
Practice Address - Street 1:2255 SW 32ND AVE
Practice Address - Street 2:SUITE # 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3177
Practice Address - Country:US
Practice Address - Phone:786-879-6292
Practice Address - Fax:786-953-6439
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL3016363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS76165Medicare UPIN