Provider Demographics
NPI:1871524561
Name:SALVATI, CARL (MD, FACP)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:SALVATI
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13455 MILITARY TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1320
Mailing Address - Country:US
Mailing Address - Phone:561-495-4644
Mailing Address - Fax:561-495-5191
Practice Address - Street 1:13455 MILITARY TRL
Practice Address - Street 2:SUITE A
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-1320
Practice Address - Country:US
Practice Address - Phone:561-495-4644
Practice Address - Fax:561-495-5191
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00504732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC54090Medicare UPIN
K0772Medicare ID - Type Unspecified