Provider Demographics
NPI:1750379897
Name:SALTZMAN, MARC ALAN (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:ALAN
Last Name:SALTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17971 BISCAYNE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2532
Mailing Address - Country:US
Mailing Address - Phone:305-933-1113
Mailing Address - Fax:305-759-4707
Practice Address - Street 1:17971 BISCAYNE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2532
Practice Address - Country:US
Practice Address - Phone:305-933-1113
Practice Address - Fax:305-759-4707
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0020954207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056737000Medicaid
FL92206UMedicare PIN
FL056737000Medicaid