Basic Information
| Provider Information | |||||||||
| NPI: | 1104560564 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SALTZMAN, TANIS, PITTEL, LEVIN AND JACOBSON, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 S PINE ISLAND RD STE 800 | ||||||||
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| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549676400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3155 CITRUS TOWER BLVD | ||||||||
| Address2: | |||||||||
| City: | CLERMONT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347116803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525574965 | ||||||||
| FaxNumber: | 3524046955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2022 | ||||||||
| LastUpdateDate: | 04/22/2022 | ||||||||
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| AuthorizedOfficialLastName: | NEEL | ||||||||
| AuthorizedOfficialFirstName: | DARLENE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9549676400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.