Provider Demographics
NPI:1174579536
Name:SALTZ, BRUCE LAWRENCE (MD)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:LAWRENCE
Last Name:SALTZ
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 1:4800 N FEDERAL HWY
Mailing Address - Street 2:SUITE E - 102
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5188
Mailing Address - Country:US
Mailing Address - Phone:561-368-8430
Mailing Address - Fax:561-362-5575
Practice Address - Street 1:4800 N FEDERAL HWY
Practice Address - Street 2:E 102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5188
Practice Address - Country:US
Practice Address - Phone:561-368-8430
Practice Address - Fax:561-362-5575
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00565152084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14784OtherBC/BS FL PROVIDER ID NO.
FLME0056515OtherMEDICAL EXAMINER'S NUMBER
FLP472483OtherOXFORD INS. ID. NO.
FLP472483OtherOXFORD INS. ID. NO.
FLME0056515OtherMEDICAL EXAMINER'S NUMBER
FLP472483OtherOXFORD INS. ID. NO.