Provider Demographics
NPI:1477558500
Name:SALCEDO, WILLIAM (DPM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:SALCEDO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 NW FEDERAL HWY # 245
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9315
Mailing Address - Country:US
Mailing Address - Phone:772-631-3326
Mailing Address - Fax:772-283-8087
Practice Address - Street 1:2515 NW FEDERAL HWY # 245
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9315
Practice Address - Country:US
Practice Address - Phone:772-631-3326
Practice Address - Fax:772-283-8087
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2253213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1477558500OtherOTHER INSURANCES
FL65266OtherBC/BS OF FL
FL480029323OtherMEDICARE RAIL ROAD
FL390067300Medicaid
FL480029323OtherMEDICARE RAIL ROAD
FL0961430001Medicare NSC