Provider Demographics
NPI:1932548146
Name:SALTZMAN, MEGAN SANDORA (DPM)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:SANDORA
Last Name:SALTZMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:JO
Other - Last Name:SANDORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1611 53RD AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-2868
Mailing Address - Country:US
Mailing Address - Phone:941-753-9599
Mailing Address - Fax:941-755-0261
Practice Address - Street 1:1611 53RD AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-2868
Practice Address - Country:US
Practice Address - Phone:941-753-9599
Practice Address - Fax:941-755-0261
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006495213ES0103X
FLPO4130213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO4130OtherMEDICAL LICENSE