Provider Demographics
NPI:1528077609
Name:SALADO, ERICK M (MD)
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:M
Last Name:SALADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 W 16TH AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7189
Mailing Address - Country:US
Mailing Address - Phone:305-826-4570
Mailing Address - Fax:305-827-1404
Practice Address - Street 1:4445 W 16TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7189
Practice Address - Country:US
Practice Address - Phone:305-826-4570
Practice Address - Fax:305-827-1404
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0056414208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062378400Medicaid
FL08307CMedicare ID - Type UnspecifiedMEDICARE