1538185939 NPI number — VERONIQUE FERNANDEZ-SALVADOR MD

Table of content: VERONIQUE FERNANDEZ-SALVADOR MD (NPI 1538185939)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538185939 NPI number — VERONIQUE FERNANDEZ-SALVADOR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ-SALVADOR
Provider First Name:
VERONIQUE
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:
TRAN
Provider Other First Name:
VERONIQUE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538185939
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2234 COLONIAL BOULEVARD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33907-1412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-931-7342
Provider Business Mailing Address Fax Number:
239-931-7385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7451 GLADIOLUS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33908-5193
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-689-8800
Provider Business Practice Location Address Fax Number:
239-790-5471
Provider Enumeration Date:
07/15/2006

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: 208800000X , with the licence number:  ME96165 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 54326 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7369781 . This is a "AETNA PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: U8195V . This is a "MEDICARE FOR LAB LOCATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0466227-001 . This is a "CIGNA PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 273627300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: ME96154 . This is a "METCARE PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 11621 . This is a "UNIVERSAL HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1193028 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00344546 . This is a "RAILROAD MEDICARE PIN #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1538185939 . This is a "MD MEDICARE CHOICE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00471488 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 020884000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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