Provider Demographics
NPI:1063081230
Name:ERRERA SALAZAR, GEORGE GIUSTO (MSN-FNP)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:GIUSTO
Last Name:ERRERA SALAZAR
Suffix:
Gender:M
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13198 SW 10TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2059
Mailing Address - Country:US
Mailing Address - Phone:305-824-7762
Mailing Address - Fax:
Practice Address - Street 1:8501 SW 124TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4627
Practice Address - Country:US
Practice Address - Phone:305-595-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily