Provider Demographics
NPI:1871851501
Name:SALVUS LLC
Entity Type:Organization
Organization Name:SALVUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALAZAR-VUST
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:786-953-6479
Mailing Address - Street 1:2255 SW 32ND AVE
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3177
Mailing Address - Country:US
Mailing Address - Phone:786-953-6479
Mailing Address - Fax:
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:786-953-6479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HCC7882261Q00000X
261QM1300X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherAHCA LIC- HCC7882