Provider Demographics
NPI:1801380969
Name:SALVATORI, PAUL ANTHONY II
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANTHONY
Last Name:SALVATORI
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TILTONSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43963-1061
Mailing Address - Country:US
Mailing Address - Phone:614-256-0434
Mailing Address - Fax:
Practice Address - Street 1:3452 LAKE LYNDA DR # DR200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1430
Practice Address - Country:US
Practice Address - Phone:407-308-3852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist