Provider Demographics
NPI:1881713790
Name:SALZBERG, ROBERT BARRY (PT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BARRY
Last Name:SALZBERG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 OAK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7546
Mailing Address - Country:US
Mailing Address - Phone:941-906-8563
Mailing Address - Fax:
Practice Address - Street 1:9070 58TH DR E STE 102
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-6110
Practice Address - Country:US
Practice Address - Phone:941-906-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY055POtherBLUE CROSS BLUE SHIELD
FLY055POtherBLUE CROSS BLUE SHIELD