Provider Demographics
NPI:1245259084
Name:SALAZAR, ROBERT FRANK (ARNP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:FRANK
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5071 SW 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4404
Mailing Address - Country:US
Mailing Address - Phone:954-655-0779
Mailing Address - Fax:954-252-1849
Practice Address - Street 1:5071 SW 119TH AVE
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-4404
Practice Address - Country:US
Practice Address - Phone:954-655-0779
Practice Address - Fax:954-252-1849
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3248502363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ51320Medicare UPIN