Provider Demographics
NPI:1962504969
Name:SENZATIMORE, SALVATORE JR (MD)
Entity Type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:
Last Name:SENZATIMORE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1695
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33402-1695
Mailing Address - Country:US
Mailing Address - Phone:561-659-5466
Mailing Address - Fax:561-659-5493
Practice Address - Street 1:1117 N OLIVE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3520
Practice Address - Country:US
Practice Address - Phone:561-659-5466
Practice Address - Fax:561-659-5493
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60151207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14892OtherBCBS
FL370045300Medicaid
FL370045301Medicaid
FL370045301Medicaid
FL370045300Medicaid
FL14892OtherBCBS