Provider Demographics
NPI:1700143443
Name:SALVAGGIO, TAMI (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:
Last Name:SALVAGGIO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15951 MCGREGOR BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-2552
Mailing Address - Country:US
Mailing Address - Phone:239-433-5995
Mailing Address - Fax:239-288-4916
Practice Address - Street 1:15951 MCGREGOR BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2552
Practice Address - Country:US
Practice Address - Phone:239-433-5995
Practice Address - Fax:239-288-4916
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA56557174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist