Provider Demographics
NPI:1013935766
Name:SALAS RUSHFORD, JAIME ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ANTONIO
Last Name:SALAS RUSHFORD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:559 CALLE CABO H ALVERIO
Mailing Address - Street 2:EXT. ROOSEVELT
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3725
Mailing Address - Country:US
Mailing Address - Phone:786-467-0606
Mailing Address - Fax:787-963-1344
Practice Address - Street 1:559 CALLE CABO H ALVERIO
Practice Address - Street 2:EXT. ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3725
Practice Address - Country:US
Practice Address - Phone:786-467-0606
Practice Address - Fax:787-963-1433
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME97798207R00000X
PR16462208D00000X, 207R00000X
NY240913208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5406U1Medicare PIN
NYI58018Medicare UPIN