Provider Demographics
NPI:1912770355
Name:SALVADOR, LETY
Entity Type:Individual
Prefix:
First Name:LETY
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 PINEHURST DR # 111
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1532
Mailing Address - Country:US
Mailing Address - Phone:813-619-0076
Mailing Address - Fax:
Practice Address - Street 1:8407 PINEHURST DR # 111
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1532
Practice Address - Country:US
Practice Address - Phone:813-619-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care