1225438666 NPI number — MARIARITA SALVITTI FERMIN MD

Table of content: ANISA ALI (NPI 1538934336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225438666 NPI number — MARIARITA SALVITTI FERMIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALVITTI FERMIN
Provider First Name:
MARIARITA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225438666
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 746450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-6450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-434-3626
Provider Business Mailing Address Fax Number:
251-445-2464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 CENTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36604-1541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-410-5437
Provider Business Practice Location Address Fax Number:
251-410-5437
Provider Enumeration Date:
09/03/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2088P0231X , with the licence number:  ME131447 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2088P0231X , with the licence number: L.5565SP , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20412700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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