Provider Demographics
NPI:1467260455
Name:RODRIGUEZ SALAZAR, WILLIANS FELIPE (SA-C)
Entity type:Individual
Prefix:
First Name:WILLIANS
Middle Name:FELIPE
Last Name:RODRIGUEZ SALAZAR
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 FOREST LAKES BLVD APT 304
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2342
Mailing Address - Country:US
Mailing Address - Phone:239-212-7594
Mailing Address - Fax:
Practice Address - Street 1:501 FOREST LAKES BLVD APT 304
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-2342
Practice Address - Country:US
Practice Address - Phone:239-212-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-550246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant