Provider Demographics
NPI:1992380091
Name:SALGUERO, PAOLA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ALEJANDRA
Last Name:SALGUERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5958 COY GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6750
Mailing Address - Country:US
Mailing Address - Phone:561-906-0855
Mailing Address - Fax:
Practice Address - Street 1:5958 COY GLEN WAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6750
Practice Address - Country:US
Practice Address - Phone:561-906-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF03210450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF03210450OtherAPRN NUMBER