Provider Demographics
NPI:1821504689
Name:SALAZAR, NATHALIE (HAIR LASS SPECIALIST)
Entity Type:Individual
Prefix:MRS
First Name:NATHALIE
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:HAIR LASS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 NW 113 ST
Mailing Address - Street 2:
Mailing Address - City:MAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168
Mailing Address - Country:US
Mailing Address - Phone:305-761-0047
Mailing Address - Fax:
Practice Address - Street 1:750 NW 113TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2219
Practice Address - Country:US
Practice Address - Phone:305-761-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management