Provider Demographics
NPI:1952588428
Name:YANIRA E SALAS DPM PA
Entity Type:Organization
Organization Name:YANIRA E SALAS DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:YANIRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-412-2445
Mailing Address - Street 1:13742 NW 18TH CT STE 2
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2603
Mailing Address - Country:US
Mailing Address - Phone:305-412-2445
Mailing Address - Fax:305-412-2446
Practice Address - Street 1:9300 SW 87TH AVE
Practice Address - Street 2:STE 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2413
Practice Address - Country:US
Practice Address - Phone:305-412-2445
Practice Address - Fax:305-412-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1311130001Medicare NSC