Provider Demographics
NPI:1770031296
Name:FONT, SALVADOR JR
Entity Type:Individual
Prefix:
First Name:SALVADOR
Middle Name:
Last Name:FONT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 STICKNEY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-5065
Mailing Address - Country:US
Mailing Address - Phone:216-225-1450
Mailing Address - Fax:216-912-8081
Practice Address - Street 1:3614 STICKNEY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-5065
Practice Address - Country:US
Practice Address - Phone:216-225-1450
Practice Address - Fax:216-912-8081
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN940041347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle